Abstract 15066: Low Physical Activity and Short Sleep predict Cardiovascular Mortality in Former Male Athletes and Their Controls

Abstract

Background: Both short and long sleep associate with mortality, and physical activity potentially influences these associations. Former athletes are often physically more active and have a healthier lifestyle also later in life than non-athletic peers. Our aim was to study the interrelationship between sleep, physical activity and mortality in a cohort of former athletes and their healthy controls. Methods: The prospective cohort consists of male athletes who competed at national team-level between 1920-1965 and their healthy controls. A baseline health questionnaire was sent to all subjects alive in 1985. The cohort was followed for mortality from national registers until December 31, 2011. Hazard ratios (HR) and 95 % confidence intervals (CI) for all-cause and cardiovascular mortality were estimated by Cox proportional hazards models with age as the time variable and age at baseline in 1985 as the entry. Sleep duration, sleep quality and physical activity level in 1985 were the main predictive variables. Results: At baseline, 2141 cohort members answered to the questionnaire, and 1388 (871 former athletes, 517 controls) provided adequate information for the analyses. Former athletes and controls differed in baseline sleep duration, sleep quality and physical activity level. However, these behaviors did not predict mortality neither in athletes or controls after adjustment for baseline socioeconomic status, BMI, smoking, alcohol use, chronotype and history of disease. A significant interaction between sleep duration and physical activity predicting all-cause and cardiovascular mortality was detected. After full adjustments, those sleeping less than 6 hours and having less than 450 MET-hours per week of physical activity had a higher risk for cardiovascular mortality (HR 1.78, 95% CI 1.06-3.00) than those sleeping 6.5 to 8.5 hours and having at least 450 MET-hours physical activity. Conclusions: We found a combination of short sleep and low physical activity to be predictive of cardiovascular mortality irrespective of a previous sports career. Neither sleep duration nor sleep quality alone predicted mortality in former athletes or controls, suggesting important clustering of health behaviors.