Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general population

BackgroundThis study investigates the joint effect of sleep patterns and oxidative balance score (OBS) on all-cause and CVD mortality in the general population.MethodsWe examined 21,427 individuals aged 18–85 from NHANES 2005–2014, connecting them to mortality data until December 31, 2019, using int...

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Main Authors: Chen Chen, Hanzhang Wu, Hongyu Jin, Zhiping Jiang, Wei Wang, Xiao Tan, Wen-Yang Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1521123/full
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author Chen Chen
Hanzhang Wu
Hanzhang Wu
Hongyu Jin
Zhiping Jiang
Wei Wang
Xiao Tan
Xiao Tan
Wen-Yang Li
author_facet Chen Chen
Hanzhang Wu
Hanzhang Wu
Hongyu Jin
Zhiping Jiang
Wei Wang
Xiao Tan
Xiao Tan
Wen-Yang Li
author_sort Chen Chen
collection DOAJ
description BackgroundThis study investigates the joint effect of sleep patterns and oxidative balance score (OBS) on all-cause and CVD mortality in the general population.MethodsWe examined 21,427 individuals aged 18–85 from NHANES 2005–2014, connecting them to mortality data until December 31, 2019, using interview and physical examination dates. Surveys collected data on sleep duration, self-reported sleep disturbance, and doctor-told sleep disorders, classified into healthy, intermediate, and unhealthy sleep patterns. OBS was calculated based on twenty oxidative stress-related exposures to dietary and lifestyle factors. Cox proportional hazards model was conducted to evaluate the association between sleep patterns or OBS alone and combined with all-cause and CVD mortality.ResultsPoor sleep patterns and pro-oxidant OBS (Q1 & Q2) were identified as risk factors for mortality. Each point increase in OBS was associated with a 3% decrease in both all-cause mortality and CVD mortality. There was an interaction between sleep patterns and OBS (P for interaction = 0.013). Joint analyses revealed that participants with combined unhealthy (intermediate and poor) sleep pattern and pro-oxidant OBS were significantly associated with increased risk of all-cause (HR = 1.45 [1.21–1.74]) and CVD mortality (HR = 1.60 [1.12–2.28]). Furthermore, stratified analysis highlighted that this joint effect was more prominent among individuals without hypertension or diabetes; more notable for all-cause mortality in younger individuals and for CVD mortality in the elderly.ConclusionWe identified a significant interaction between sleep patterns and OBS affecting all-cause mortality. Unhealthy sleep patterns and pro-oxidant OBS were jointly and positively associated with an increased risk of all-cause and CVD mortality. Interventions targeting healthy sleep patterns and antioxidant lifestyles may promote health outcomes.
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spelling doaj-art-a79643480ec942328ddf18b521d0f2292025-01-29T15:27:46ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011210.3389/fnut.2025.15211231521123Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general populationChen Chen0Hanzhang Wu1Hanzhang Wu2Hongyu Jin3Zhiping Jiang4Wei Wang5Xiao Tan6Xiao Tan7Wen-Yang Li8Respiratory and Critical Care Department, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaRespiratory and Critical Care Department, The First Hospital of China Medical University, Shenyang, ChinaRespiratory and Critical Care Department, The First Hospital of China Medical University, Shenyang, ChinaRespiratory and Critical Care Department, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaRespiratory and Critical Care Department, The First Hospital of China Medical University, Shenyang, ChinaBackgroundThis study investigates the joint effect of sleep patterns and oxidative balance score (OBS) on all-cause and CVD mortality in the general population.MethodsWe examined 21,427 individuals aged 18–85 from NHANES 2005–2014, connecting them to mortality data until December 31, 2019, using interview and physical examination dates. Surveys collected data on sleep duration, self-reported sleep disturbance, and doctor-told sleep disorders, classified into healthy, intermediate, and unhealthy sleep patterns. OBS was calculated based on twenty oxidative stress-related exposures to dietary and lifestyle factors. Cox proportional hazards model was conducted to evaluate the association between sleep patterns or OBS alone and combined with all-cause and CVD mortality.ResultsPoor sleep patterns and pro-oxidant OBS (Q1 & Q2) were identified as risk factors for mortality. Each point increase in OBS was associated with a 3% decrease in both all-cause mortality and CVD mortality. There was an interaction between sleep patterns and OBS (P for interaction = 0.013). Joint analyses revealed that participants with combined unhealthy (intermediate and poor) sleep pattern and pro-oxidant OBS were significantly associated with increased risk of all-cause (HR = 1.45 [1.21–1.74]) and CVD mortality (HR = 1.60 [1.12–2.28]). Furthermore, stratified analysis highlighted that this joint effect was more prominent among individuals without hypertension or diabetes; more notable for all-cause mortality in younger individuals and for CVD mortality in the elderly.ConclusionWe identified a significant interaction between sleep patterns and OBS affecting all-cause mortality. Unhealthy sleep patterns and pro-oxidant OBS were jointly and positively associated with an increased risk of all-cause and CVD mortality. Interventions targeting healthy sleep patterns and antioxidant lifestyles may promote health outcomes.https://www.frontiersin.org/articles/10.3389/fnut.2025.1521123/fullsleep disorderoxidative balance scoredietlifestylemortalityNational Health and Nutrition Examination Survey (NHANES)
spellingShingle Chen Chen
Hanzhang Wu
Hanzhang Wu
Hongyu Jin
Zhiping Jiang
Wei Wang
Xiao Tan
Xiao Tan
Wen-Yang Li
Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general population
Frontiers in Nutrition
sleep disorder
oxidative balance score
diet
lifestyle
mortality
National Health and Nutrition Examination Survey (NHANES)
title Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general population
title_full Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general population
title_fullStr Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general population
title_full_unstemmed Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general population
title_short Joint association of sleep patterns and oxidative balance score with all-cause and cardiovascular mortality among the general population
title_sort joint association of sleep patterns and oxidative balance score with all cause and cardiovascular mortality among the general population
topic sleep disorder
oxidative balance score
diet
lifestyle
mortality
National Health and Nutrition Examination Survey (NHANES)
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1521123/full
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