Healthy sleep patterns and risk of hospitalization for infection: a large community-based cohort study

Sleep behaviours are potentially modifiable risk factors for infectious disease. However, little is known about the combined effects of multiple sleep factors on the risk of infections. We investigated the prospective associations of combined healthy sleep patterns with the risk of hospitalization for infection in 397,523 participants (mean (SD) age: 56.3 (8.1) years) from the UK Biobank. Healthy sleep patterns were defined by healthy sleep scores according to a combination of adequate sleep duration (7-8 h/day), early chronotype, no insomnia, and no excessive daytime sleepiness. During a median follow-up of 13.5 (interquartile range: 12.4-14.2) years, 60,377 cases of hospitalization for any infection were documented. A healthy sleep score was inversely associated with the risk of hospitalization for any infection and various infection subtypes in a dose-dependent manner (P for trend < 0.001). The associations between a one-point increment of healthy sleep score and hospitalization for infections ranged from a 9% lower risk for sepsis (HR = 0.91; 95% CI, 0.89-0.93) to a 20% lower risk for liver infection (HR = 0.80; 95% CI, 0.74-0.87). More than 10% of hospitalizations for any infection could have been prevented if all participants adhered to the four low-risk sleep behaviours. Adherence to a healthy sleep pattern was associated with a decreased risk of hospitalization for infections, especially for individuals <65 years of age and females (P for interaction < 0.00045). Our findings highlight the potential of sleep behaviour interventions for the primary prevention of infectious diseases.