Regularity of bedtime, wake-up time, and time in bed in mid-life: associations with cardiometabolic health markers with adjustment for physical activity and sedentary time.

BACKGROUND: Insufficient sleep has been linked to the accumulation of cardiometabolic risks while physical activity acts as a protective factor. Also, sleep regularity may play a critical role in maintaining optimal cardiometabolic health. This cross-sectional study examined the association between device-based sleep regularity, waking activity behaviors, and cardiometabolic health markers, including blood pressure level; abdominal adiposity level; and blood glucose, insulin, and cholesterol. METHODS: We included 3698 members of the Northern Finland Birth cohort 1966 who participated in the follow-up study at the age of 46 years between 2012 and 2014 (women 61%). We used seven-day standard deviations of device-based bedtime, wake-up time, and time in bed to reflect sleep regularities. As covariates in linear regression models, we used commonly known potential risk factors in (gender, education, marital status, work schedule, smoking status, alcohol risk use, seven-day time in bed mean, chronotype). In addition to the previous, we used either sedentary time or total physical activity as a covariate (B coefficients with 95% confidence intervals CI). RESULTS: When we considered sedentary time with other covariates, irregularities in bedtime, wake-up time, and time in bed were associated with unfavorable cardiometabolic health markers, such as higher body mass index (bedtime regularity: 0.194, 95% CI [0.072, 0.316], p = 0.002); higher diastolic blood pressure levels (time in bed regularity: 0.175, 95% CI [0.044, 0.306], p = 0.009); and higher 2-h glucose levels (wake-up time regularity: 0.107, 95% CI [0.030, 0.184], p = 0.006). When we considered total physical activity with other covariates, only irregular bedtime was associated with higher waist circumference (B 0.199, 95% CI [0.042, 0.356], p = 0.013). Irregularities in bedtime and wake-up time were not associated with higher diastolic blood pressure, higher visceral fat area or higher fasting insulin level after considering sedentary time or total physical activity with other covariates (in all, p > 0.05). CONCLUSIONS: In middle-aged, physical activity appears to weaken the adverse relationship between irregular sleep and cardiometabolic health markers, although the interpretation of the impact of sedentary time remains less conclusive. The clinical significance and extent of the observed associations warrant further investigation.