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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Education and Promotion
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1532320
This article is part of the Research Topic Living With and Beyond Cancer Across the Lifespan View all 9 articles

Interaction between sleep duration and physical activity on mortality among cancer survivors: Findings from National Health and Nutrition Examination Surveys 2007-2018

Provisionally accepted
Ruyan Chen Ruyan Chen Jianglong Han Jianglong Han Si Li Si Li Haiyu Deng Haiyu Deng Tingting Jian Tingting Jian Zheyu Huang Zheyu Huang Yuxuan Wei Yuxuan Wei Zhenming Fu Zhenming Fu *
  • Renmin Hospital of Wuhan University, Wuhan, China

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

    Background Sleep duration and physical activity (PA) are critical factors influencing mortality risk. However, the interaction between sleep duration and PA with mortality risk among cancer survivors has not been well explored. Methods This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007-2018. Multivariable Cox regression analysis and restricted cubic splines were employed to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the association of sleep duration and PA with mortality risk in cancer survivors. Multiplicative and additive interaction terms were constructed to assess interaction effects. Results The study included a total of 2,528 adult cancer survivors (aged≥20 years). Sleep duration exhibited a U-shaped association with all-cause and cancer-specific mortality, while demonstrating an inverted L-shaped association with cardiovascular disease (CVD) mortality. Compared to physically inactive participants, those with adequate PA had lower risks of all-cause mortality (HR = 0.542, 95% CI: 0.540-0.543), cancer mortality (HR = 0.486, 95% CI: 0.484-0.488), and CVD mortality (HR = 0.759, 95% CI: 0.755-0.763) among cancer survivors. A significant additive interaction was found between extreme sleep duration and PA on all-cause mortality risk among cancer survivors (long sleep duration: relative excess risk due to interaction (RERI) = 1.514, 95% CI: 1.504-1.525; short sleep duration: RERI = 0.725, 95% CI: 0.713-0.737). Conclusion Extreme sleep duration and lack of PA were associated with mortality risk in cancer survivors independently and jointly. Maintain appropriate sleep duration and doing regular PA may synergistically improve cancer survival among cancer survivors.

    Keywords: sleep duration, physical activity, Cancer, Mortality, national Health and Nutrition Examination Survey (NHANES)

    Received: 21 Nov 2024; Accepted: 03 Jan 2025.

    Copyright: © 2025 Chen, Han, Li, Deng, Jian, Huang, Wei and Fu. 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: Zhenming Fu, Renmin Hospital of Wuhan University, Wuhan, China

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