Association of healthy sleep patterns with incident sepsis: a large population-based prospective cohort study.

Summary

In a 409,570-participant UK Biobank cohort followed for a mean of 13.54 years, each one-point increase in a five-behavior healthy sleep score was associated with a 5% lower risk of incident sepsis (HR 0.95, 95% CI 0.93-0.97). The inverse association was stronger in participants <60 years; healthy sleep was not associated with sepsis-related death or critical care admission.

Key Findings

• Each 1-point increase in healthy sleep score was associated with a 5% lower sepsis risk (HR 0.95, 95% CI 0.93-0.97).
• Participants with the healthiest sleep (score 5) had a 24% lower sepsis risk vs score 0-1 (HR 0.76, 95% CI 0.69-0.83).
• Stronger inverse association in participants <60 years (interaction p<0.001); no association with sepsis-related death or critical care admission.

Clinical Implications

Clinicians can incorporate sleep health counseling into preventive care for at-risk adults and consider sleep patterns in sepsis risk stratification, especially for individuals under 60. Causal inference requires trials before implementing sleep interventions to reduce sepsis incidence.

Limitations

• Sleep behaviors largely self-reported, potential misclassification
• Observational design limits causal inference; residual confounding possible

Future Directions

Randomized or quasi-experimental trials to test sleep interventions for sepsis prevention, mechanistic studies linking sleep biology to infection susceptibility, and validation across diverse populations.