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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1521123

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

Provisionally accepted
Chen Chen Chen Chen 1Hanzhang Wu Hanzhang Wu 2*Hongyu Jin Hongyu Jin 1Zhiping Jiang Zhiping Jiang 1Wei Wang Wei Wang 1Xiao Tan Xiao Tan 2*Wen-Yang Li Wen-Yang Li 1*
  • 1 The First Affiliated Hospital of China Medical University, Shenyang, China
  • 2 Department of Big Data and Health Science, School of Public Health, Zhejiang University, Hangzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    Background: This study investigates the joint effect of sleep patterns and oxidative balance score (OBS) on all-cause and CVD mortality in the general population. Methods: We 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. Results: Poor 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. We 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.

    Keywords: sleep disorder, Oxidative balance score, Diet, lifestyle, Mortality, NHANES (National Health and Nutrition Examination Survey)

    Received: 01 Nov 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Chen, Wu, Jin, Jiang, Wang, Tan and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hanzhang Wu, Department of Big Data and Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, Jiangsu Province, China
    Xiao Tan, Department of Big Data and Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, Jiangsu Province, China
    Wen-Yang Li, The First Affiliated Hospital of China Medical University, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.