Associations of nighttime sleep, midday napping, and physical activity with all-cause mortality in older adults: the Seniors-ENRICA cohorts

We examined associations between nighttime sleep and midday nap duration with all-cause mortality according to adherence to moderate-to-vigorous physical activity (MVPA) recommendations in older adults. We used data from 3518 and 3273 older adults recruited in the Seniors-ENRICA-1 and 2 cohorts, respectively. Nighttime sleep time was classified as short (< 7 h), middle (≥ 7 and < 8 h), and long (≥ 8 h), and midday napping as no nap, short (≤ 30 min), long (> 30 and ≤ 60 min), and very long (> 60 min). Time spent in MVPA was classified as meeting (i.e., ≥ 150 min/week) or not the MVPA recommendations. All-cause mortality was the main outcome. Analyses were performed with Cox regression and adjusted for the main confounders. Overall, compared with middle nighttime sleep, both short (HR 1.20; 95% CI 1.03–1.39) and long (HR 1.30; 95% CI 1.12–1.52) were associated with higher mortality. Among participants who did not meet MVPA recommendations, the association between short (HR 1.22; 95% CI 1.01–1.48) and long (HR 1.46; 95% CI 1.21–1.77) sleeping duration mortality remained. Short napping was associated with lower mortality (HR 0.83; 95% CI 0.71–0.96) and very long with higher mortality (HR 1.29; 95% CI 1.04–1.59), compared to those who did not nap. Among participants not meeting MVPA recommendations, only very long napping was associated with increased mortality (HR 1.32; 95% CI 1.01–1.73). No associations were identified between nighttime sleep or midday napping with mortality among participants meeting MVPA recommendations. Meeting MVPA recommendations can attenuate the risks associated with short or long sleep duration.