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Paper

Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study

Daniel P Windred, Angus C Burns, Jacqueline M Lane, Richa Saxena, Martin K Rutter, Sean W Cain +1 more
SLEEP2023CC BY 4.0
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Published articlePublication date: Sep 21, 2023Added to atlas: Oct 15, 2026Source
Citations271Crossref referencesChecked Oct 16, 2026
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Activity counts measure attention, not model quality. Missing counts are unknown. Publication status follows the linked source; a listed venue alone does not confirm peer review.

Windred and colleagues calculated Sleep Regularity Index scores from more than 10 million hours of accelerometer data in 60,977 UK Biobank participants (median SRI 81.0) and compared sleep regularity with sleep duration as predictors of mortality. Across the top four SRI quintiles versus the least regular, higher regularity was associated with 20-48% lower all-cause, 16-39% lower cancer and 22-57% lower cardiometabolic mortality. Sleep regularity was a stronger predictor of all-cause mortality than sleep duration.

  • Signals: Accelerometer
  • Result: The authors calculated Sleep Regularity Index (SRI) scores from > 10 million hours of accelerometer data in 60 977 UK Biobank participants (62.8 ± 7.8 years, 55.0% female, median[IQR] SRI: 81.0[73.8–86.3]).
  • Result: Higher sleep regularity was associated with a 20%–48% lower risk of all-cause mortality (p < .001 to p = 0.004), a 16%–39% lower risk of cancer mortality (p < 0.001 to p = 0.017), and a 22%–57% lower risk of cardiometabolic mortality (p < 0.001 to…
At a glance
Venue
SLEEP
Published
2023
DOI
10.1093/sleep/zsad253 (opens in a new tab)
arXiv
Not reported
PMID
Not reported
Licence
CC BY 4.0 (opens in a new tab)
Signals
Not reported
Form factor
Not reported
Devices
Datasets
Subjects
1859 participants
Code
Not reported
Added
Oct 15, 2026

Abstract

Abnormally short and long sleep are associated with premature mortality, and achieving optimal sleep duration has been the focus of sleep health guidelines. Emerging research demonstrates that sleep regularity, the day-to-day consistency of sleep–wake timing, can be a stronger predictor for some health outcomes than sleep duration. The role of sleep regularity in mortality, however, has not been investigated in a large cohort with objective data. We therefore aimed to compare how sleep regularity and duration predicted risk for all-cause and cause-specific mortality. We calculated Sleep Regularity Index (SRI) scores from > 10 million hours of accelerometer data in 60 977 UK Biobank participants (62.8 ± 7.8 years, 55.0% female, median[IQR] SRI: 81.0[73.8–86.3]). Mortality was reported up to 7.8 years after accelerometer recording in 1859 participants (4.84 deaths per 1000 person-years, mean (±SD) follow-up of 6.30 ± 0.83 years). Higher sleep regularity was associated with a 20%–48% lower risk of all-cause mortality (p < .001 to p = 0.004), a 16%–39% lower risk of cancer mortality (p < 0.001 to p = 0.017), and a 22%–57% lower risk of cardiometabolic mortality (p < 0.001 to p = 0.048), across the top four SRI quintiles compared to the least regular quintile. Results were adjusted for age, sex, ethnicity, and sociodemographic, lifestyle, and health factors. Sleep regularity was a stronger predictor of all-cause mortality than sleep duration, by comparing equivalent mortality models, and by comparing nested SRI-mortality models with and without sleep duration (p = 0.14–0.20). These findings indicate that sleep regularity is an important predictor of mortality risk and is a stronger predictor than sleep duration. Sleep regularity may be a simple, effective target for improving general health and survival.

Verbatim fromthe publisher's DOI record· Publisher licence: https://creativecommons.org/licenses/by/4.0/

Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study: ChatPPG research summary card

How it works

How Method works: Setup → Method → ResultSetup: Cohort (1859 participants); Signals (Accelerometer). Method: Method. Result: Result (The authors calculated Sleep Regularity Index (SRI) scores from &gt; 10 million hours of accelerometer data in 60 977 UK Biobank participants (62.8 ± 7.8 years, 55.0% female, median[IQR] SRI: 81.0[73.8–86.3]).); Result (Higher sleep regularity was associated with a 20%–48% lower risk of all-cause mortality (p &lt; .001 to p = 0.004), a 16%–39% lower risk of cancer mortality (p &lt; 0.001 to p = 0.017), and a 22%–57% lower risk of cardiometabolic mortality (p &lt; 0.001 to…).SetupCohort: 1859 participantsCohort1859 participantsSignals: AccelerometerxyzSignalsAccelerometerMethodMethodResultResult: The authors calculated Sleep Regularity Index (SRI) scores from &gt; 10 million hours of accelerometer data in 60 977 UK Biobank participants (62.8 ± 7.8 years, 55.0% female, median[IQR] SRI: 81.0[73.8–86.3]).ResultThe authors calculated Sleep Regularity…Result: Higher sleep regularity was associated with a 20%–48% lower risk of all-cause mortality (p &lt; .001 to p = 0.004), a 16%–39% lower risk of cancer mortality (p &lt; 0.001 to p = 0.017), and a 22%–57% lower risk of cardiometabolic mortality (p &lt; 0.001 to…ResultHigher sleep regularity was associated…
Cohort
1859 participants

Devices· 1

Axivity AX3
Axivity · Wrist
IMU

Illustrations by form factor; product photos are added as licences clear.

Datasets used· 1

Dataset
UK Biobank wrist accelerometer (Axivity AX3 / field 90001)
103,568 subjects · uk-biobank
IMU

Cite

@article{windredsleepregularitymo2023,
  title = {{Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study}},
  author = {Daniel P Windred and Angus C Burns and Jacqueline M Lane and Richa Saxena and Martin K Rutter and Sean W Cain and Andrew J K Phillips},
  year = {2023},
  journal = {SLEEP},
  doi = {10.1093/sleep/zsad253}
}

History

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