Abstract Background Sleep is a fundamental physiological process essential for restorative and regulatory functions. Consensus guidelines, largely formulated based on self-reported data, typically recommend 7–9 hours of sleep per night. Information on the potential effects of day-to-day variability of sleep patterns and a need for regular sleep is lacking. Here, we studied the health effects of objectively measured "catch-up" sleep, where individuals compensate for insufficient sleep on some nights by sleeping longer on others to obtain a sufficient average. In view of its strong link with disturbed sleep patterns, we focused on cardiometabolic disease. Methods Using one week of accelerometer-derived sleep data from 89,573 UK Biobank participants, we classified sleep into three patterns: catch-up sleep (≥7 hours per day on average with ≥1 day having 6.5 hours), regular sleep (≥7 hours per day with ≥6.5 hours each day), and insufficient sleep (7 hours per day). Key outcomes were incident atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), and type 2 diabetes mellitus (DM). We then extended our analysis to a phenome-wide association study (PheWAS) for 762 incident conditions using a false discovery rate threshold of 5%. Cox proportional hazards models were adjusted for demographic, socioeconomic, lifestyle, and clinical factors. Sensitivity analyses were performed using an 8-hour threshold for adequate sleep, with a corresponding 7.5-hour cutoff for pattern classification. Results 67,037 participants showed regular sleep patterns, 3,767 did not sleep enough, and 18,753 had catch-up sleep. Compared with inadequate sleep, only regular sleep was associated with a lower risk of HF (HR 0.74, 0.58-0.93, p=0.01), MI (HR 0.67, 0.53-0.85, p0.001) and DM (HR 0.65, 0.53-0.81, p0.01). When compared directly to regular sleep and additionally adjusted for total sleep duration, catch-up sleep was associated with a higher risk of AF (HR 1.13, 1.03-1.25, p0.01), HF (HR 1.22, 1.07-1.39, p0.01), MI (HR 1.27, 1.11-1.47, p0.001), and DM (HR 1.29, 1.14-1.47, p0.001). In the PheWAS using inadequate sleep as the reference, catch-up sleep was associated with lower risk for 7 conditions, whereas regular sleep was associated with lower risk of 79 conditions (none with higher risk, Figure). When compared directly to regular sleep, catch-up sleep was associated with higher risk of 26 conditions and lower risk of 2 conditions (skin cancer and myopia). Results using the 8-hour threshold were comparable. Conclusion Sufficient sleep in accordance with current guidelines and following a regular pattern is associated with lower risk of future cardiometabolic outcomes as well as over 75 conditions across the spectrum of disease. Even intermittent nights with shorter sleep reduce these health benefits. Rather than simply meeting an acceptable weekly average, obtaining adequate sleep each night should be an important public health target.Figure 1:study overview Figure 2:Cox regressions and PheWAS
Kany et al. (Sat,) studied this question.