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 (2021). Published online May 06, 2021. doi: 10.1007/s11325-021-02394-0

In summary

It has been shown that incorrect sleep habits can be risk factors for healthspan termination, although lifestyle medicine could mitigate the effects.


Sleep behaviors are crucial markers of healthspan and have been included among the predictors of healthspan termination. Unhealthy sleep behaviors such as short and long sleep duration and insomnia/sleeplessness have the potential to alter numerous body functions, contributing to atherosclerosis, inflammatory responses, cardiovascular diseases (CVD), and oxidative stress. 

Additionally, excessive daytime sleepiness was associated with harmful events such as strokes, myocardial infarctions (MI), CVD, decreased quality of life, and workplace accidents.

The characteristics of the study

A recent prospective study conducted on over three hundred thousand healthy subjects – enrolled in the UK between 2006 and 2010 and followed until 2016 – analyzed four sleep behavior factors with respect to the risk of healthspan termination. Healthspan termination was defined based on eight health terminating events (congestive heart failure, myocardial infarction, chronic obstructive pulmonary disease, stroke, dementia, diabetes, cancer, and death), which are all strongly associated with longevity.


The study showed that factors of high-risk sleep behavior, such as excessive daytime sleepiness, habitually taking a nap, frequently experiencing sleeplessness/insomnia, and difficulty getting out of bed in the morning, increased the risk of healthspan termination. Moreover, the analyses showed that factors such as healthy body mass index, non-smoking status, and proper diet could lower the risk of reduced lifespan tied to poor sleep behavior.

Limits of the study

The subjects involved in the study were mainly Caucasian, limiting the generalizability of the results to other races. In addition, sleep behaviors were self-reported, therefore limiting confidence in the responses.

What is new?

This study is the first one to assess the association between these four sleep behaviors and the risk of health span termination in a large prospective cohort study.


Practicing healthy sleep behaviors is significant for extending the healthspan. The findings of this study also highlight that other Lifestyle medicine interventions could counteract the risks associated with unhealthy sleep behaviors, whenever it is not possible to directly intervene on sleep management (such as for shift workers). 

Edited by Elisabetta Bravini and Carmela Rinaldi

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