To investigate the implications of both sleep factors and sleep patterns on the prognosis of cardiometabolic multimorbidity (CMM).

From UK Biobank, individuals with CMM, defined as the coincidence of at least two cardiometabolic diseases (hypertension, diabetes mellitus, coronary heart disease, and stroke) were included in this study. Four low-risk sleep factors including early chronotype, sleep 7–8 h/day, free of insomnia, and no frequent excessive daytime sleepiness were used to generate a healthy sleep score ranging from 0 to 4. Participants with the score of 0–1, 2, 3–4 were clustered into the groups with poor, intermediate, and healthy sleep pattern, respectively. We assessed the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality using the Cox proportional hazards model.

Among included 35,757 participants, the mean age (SD) was 61.82 (6.3) years. After full adjustment, early chronotype, sleep 7–8 h/day, no frequent excessive daytime sleepiness, and free of insomnia were independently associated with 8%, 12%, 11%, and 8% lower risks of all-cause mortality among all persons with CMM. We found the full-adjusted HR (95% CI) for all-cause mortality was 0.90 (0.88–0.92) for a 1-point increase in the healthy sleep score. Compared with the reference group, participants with the intermediate and healthy sleep pattern had 9% and 23% lower risk of all-cause death, respectively, in the full-adjusted model.

A healthy sleep pattern combining four low-risk sleep factors could be regarded as a healthy lifestyle for individuals with CMM to lower the risk of all-cause mortality.