Association of healthy sleep patterns with incident sudden cardiac arrest: a prospective study of 414625 UK biobank participants

The relationship between healthy sleep patterns and the risk of incident sudden cardiac arrest (SCA) remains underexplored. In this prospective cohort study, data from 414,625 participants in the UK Biobank (UKB) were analyzed. Sleep patterns were assessed using a composite sleep score incorporating five sleep behaviors: sleep chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. The association between sleep patterns and incident SCA was evaluated using Cox proportional hazards models. Over a median follow-up of 13.93 years, 2,545 incident SCA cases were identified. In the fully adjusted Model 3, participants with sleep scores of 4 or 5 had a 19% [Hard ratio (HR) = 0.81; 95%Confidence interval (CI): 0.65-1.00] lower risk of SCA compared to those with sleep scores of 0-1, and each one-point increase in sleep score was associated with a 5% reduction in SCA risk. Restricted cubic spline analysis demonstrated a dose-response relationship between sleep scores and SCA risk, with no evidence of nonlinearity. If all individuals adhered to an optimal sleep score of 5, the incidence of SCA may potentially be reduced by 17.11%. Notably, the association between sleep scores and SCA risk was more pronounced in individuals younger than 60 years at baseline and those without chronic conditions such as coronary heart disease, hypertension, stroke, or cancer. Additionally, sleep duration, insomnia, and snoring showed significant genetic correlations with SCA. Healthy sleep patterns are associated with a significantly reduced risk of SCA, particularly among individuals younger than 60 years without cardiovascular disease, cerebrovascular disease, or cancer.