ArticleFrontiers in public health2026
Independent and joint associations of sleep duration and physical activity with cardiovascular disease: a cross-sectional study of 1.6 million US adults.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
Background: Sleep duration and physical activity are intertwined determinants of cardiovascular health, yet their joint impact remains unclear. This study evaluated their independent, joint, and interactive associations with cardiovascular disease using a rigorous confounding adjustment framework. Methods: We analyzed pooled data from 1,577,591 US adults in the Behavioral Risk Factor Surveillance System (2014-2022). Inverse probability of treatment weighting and doubly robust logistic regression were used. Additive interaction was assessed via RERI. Results: Both short sleep (odds ratio, 1.26; 95% confidence interval, 1.22-1.30) and long sleep (odds ratio, 1.17; 95% confidence interval, 1.13-1.21) were independently associated with prevalent cardiovascular disease, as was physical inactivity (odds ratio, 1.11; 95% confidence interval, 1.09-1.14). The joint effect of short sleep and inactivity conferred the highest risk (odds ratio, 1.38; 95% confidence interval, 1.31-1.44). The relative excess risk due to interaction was -0.03 (95% confidence interval, -0.11 to 0.06), indicating additive, independent risks without synergy. Conclusion: By applying a rigorous adjustment framework, this study provides actionable, population-level evidence that moves beyond simple risk factor identification. Public health strategies should integrate sleep hygiene and physical activity into holistic "24-h movement" prescriptions.
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