Device-Measured Sleep Characteristics, Daily Step Count, and Cardiometabolic Health Markers: Findings From the Prospective Physical Activity, Sitting, and Sleep (ProPASS) Consortium
Year: 2025
Type: article
Abstract: BACKGROUND: Sleep and physical activity (PA) are important lifestyle-related behaviors that impact cardiometabolic health. This study investigated the joint associations of daily step count and sleep patterns (regularity and duration) with cardiometabolic biomarkers in adults. METHODS: We conducted a cross-sectional study using pooled data from the Prospective PA, Sitting, and Sleep Consortium, comprising 6 cohorts across Europe and Australia with thigh-worn accelerometry data collected between 2011 and 2021. The sleep regularity index, a metric that quantifies day-to-day sleep consistency, sleep duration (h/d), and steps (per day), was derived from the accelerometer data and categorized based on tertiles and sleep duration guidelines. We used multivariate generalized linear models to examine joint associations of sleep patterns and total daily step count with individual cardiometabolic biomarkers, including body mass index, waist circumference, total cholesterol, HDL (high-density lipoprotein) cholesterol, triglycerides, HbA1c (glycated hemoglobin), and a composite cardiometabolic health score (mean of the 6 standardized biomarker Z scores). RESULTS: The sample included 11 903 adults with a mean±SD age of 54.7±9.5 years, 54.9% female, a sleep regularity index of 78.7±10.4, and 10 206.4±3442.2 daily steps. Lower PA (<8475 steps/d) combined with either lower sleep regularity (sleep regularity index <75.9) or short sleep duration (<7 h/d) was associated with the least favorable composite cardiometabolic health. The corresponding Z scores (95% CI) were 0.34 (0.30–0.38) and 0.26 (0.22–0.31) compared with those with optimal sleep (sleep regularity index >84.5 or 7–8 h/d) and high step count (>11 553 steps/d). The combination of low sleep regularity and low daily steps was associated with higher body mass index (2.92 [2.61–3.24] kg/m 2 ), waist circumference (8.58 [7.78–9.38] cm), total cholesterol (0.15 [0.07–0.23] mmol/L), and lower HDL levels (0.17 [0.14–0.2] mmol/L), regardless of sleep duration. The combination of short sleep and low step count had the strongest unfavorable associations for body mass index (2.31 [1.98–2.65] kg/m 2 ) and waist circumference (7.01 [6.15–7.87] cm). CONCLUSIONS: Our findings suggest that the potential deleterious associations of irregular or insufficient sleep with cardiometabolic health outcomes may be exaggerated by lower daily PA. Investigation of the prospective joint association of sleep patterns and PA with cardiometabolic health may be warranted.
Authors: Wenxin Bian, Matthew N. Ahmadi, Raaj Kishore Biswas, Joanna M. Blodgett, Andrew J. Atkin, Hsiu-Wen Chan, Borja del Pozo Cruz, Kristin Suorsa, Esmée A. Bakker, Richard M. Pulsford, Gregore I. Mielke, Peter J. Johansson, Pasan Hettiarachchi, Nicholas A. Koemel, Dick H.J. Thijssen, Sari Stenholm, Gita D. Mishra, Armando Teixeira-Pinto, Vegar Rangul, Lauren B. Sherar, Ulf Ekelund, Alun D. Hughes, I-Min Lee, Peter A. Cistulli, Andreas Holtermann, Annemarie Koster, Mark Hamer, Emmanuel Stamatakis, H. Savelberg, B. de Galan, C. van de Kallen, T. M. H. Eijsvogels
Institutions: The University of Sydney, National Institute for Health and Care Research, UCL Biomedical Research Centre, University College London, University of East Anglia, The University of Queensland, University of Turku, Turku University Hospital, Radboud University Nijmegen, Universidad de Granada, Radboud University Medical Center, University of Exeter, Uppsala University, Uppsala University Hospital, Norwegian University of Science and Technology, National Health Service, Loughborough University, University of Leicester, University Hospitals of Leicester NHS Trust, NIHR Leicester Biomedical Research Centre, Norwegian Institute of Public Health, Norwegian School of Sport Sciences, British Heart Foundation, MRC Unit for Lifelong Health and Ageing, Medical Research Council, Brigham and Women's Hospital, Harvard University, Royal North Shore Hospital, National Research Centre for the Working Environment, Maastricht University, Care and Public Health Research Institute
Language: English
Topic: Physical Activity and Health
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Brigham and Women's Hospital, National Research Centre, Harvard T.H. Chan School of Public Health, Norges Teknisk-Naturvitenskapelige Universitet, University Hospitals of Leicester NHS Trust, Australian Government, National Institute for Health and Care Research, British Heart Foundation, University of East Anglia, University of Exeter, University of Leicester, University College London, Loughborough University, University of Queensland, Radboud Universiteit, Universiteit Maastricht, Department of Health and Aged Care, Australian Government, Akademiska Sjukhuset, Turun Yliopisto, Radboud Universitair Medisch Centrum, Universidad de Granada, Uppsala Universitet, Turun Yliopistollinen Keskussairaala, Norges Idrettshøgskole, Medical Research Council, Care and Public Health Research Institute, Universiteit Maastricht, NIHR Leicester Biomedical Research Centre, Faculty of Medicine and Health, University of Sydney
OpenAlex ID: W4412640334