Get started
Work

Physical activity, sleep and cardiovascular diseases : Person-oriented and longitudinal perspectives

Year: 2016
Type: dissertation
Study design: Observational Study
Abstract: Physical activity (PA) is a well established behavioral risk factor for cardiovascular diseases (CVD), a leading cause of death globally. Also poor sleep and sedentary behaviors associate with higher CVD risk. Despite decreased CVD mortality in Finland, many people do not get enough PA, sleep-related problems are common in the working aged population and sedentary behaviors take up large parts of the time spent awake. Health behaviors tend to cluster and epidemiological literature suggest interrelationships also between PA and sleep. Associations between PA and sleep can be modified by qualitative factors, such as domain of PA, sleep quality and timing of sleep, as well as sociodemographic characteristics. The existing literature is sparse on interactions between PA and sleep with CVD and actual clustering of the behaviors has seldom been modeled in large-scale population data. The aim of this thesis was to study the interrelationship between PA and sleep and their joint association with CVD risk and mortality. The focus was on modelling inter-individual variation in the behaviors and on studying cardiometabolic risk factors and total CVD risk based on the clustering of the behaviors. Furthermore, the interrelationships between a history of sports, PA, sleep and all-cause and CVD mortality was studied in a population of former elite athletes. This study comprises data from the National FINRISK 2012 Study (n=6424, men=3041; women=3383) and the Finnish former elite athlete cohort (n=2141, all men). In the FINRISK 2012 Study, a sample of the Finnish general population aged 25 to 74-years underwent a health examination and filled in health questionnaires. The former athletes (n=1364) and non-athletic referents (n=777) of the Finnish former elite athlete cohort provided information about health behaviors on a questionnaire in 1985 and were then followed-up for mortality until 31 December 2011 from national registers. This study showed that differences in clustering of PA and sleep behaviors characterized underlying groups of men and women among the initially CVD-free, Finnish general population. Low PA, high screen time sitting, short and insufficient self-reported sleep made up a Profile, in which membership among women associated with unfavorable levels in several cardiometabolic risk factors and a higher total CVD risk. In men, membership in the Physically inactive, poor sleepers Profile showed only one statistically significant association (out of 10) with unfavorable levels in cardiometabolic risk factors, but was associated with a high estimated 10-year CVD risk. Different chronotypes in the population were strongly characterized by evening preference, but also by morning tiredness. Both evening types and tired, more evening types had low leisure time PA (LTPA) compared to morning types and evening type also had high sitting. There was a significant joint association of insufficient LTPA level and short sleep with a higher mortality, especially CVD mortality, in a cohort of former elite athletes and non-athletic referents. This study supports the importance of PA and sleep as health behaviors related to CVD risk, and provide evidence particularly for a joint association with CVD risk. Not only the duration of sleep, but also the quality and self-estimated sufficiency of sleep, as well as a person s chronotype contribute to the clustering of PA and sleep and consequent CVD risk. The results of this study are generalizable to the general adult population in Finland, apart from the mortality results that apply to a more selected male population.
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W2550050907
Cites: 7
Cited by:
Related to: 10