• Arena, R. et al. Current activities centered on healthy living and recommendations for the future: a position statement from the HL-PIVOT network. Curr. Probl. Cardiol. 46, 100823 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Kris-Etherton, P. M. et al. Strategies for promotion of a healthy lifestyle in clinical settings: pillars of ideal cardiovascular health: a science advisory from the American Heart Association. Circulation 144, e495–e514 (2021).

    PubMed 

    Google Scholar
     

  • Falck, R. S., Davis, J. C. & Liu-Ambrose, T. What is the association between sedentary behaviour and cognitive function? A systematic review. Br. J. Sports Med. 51, 800–811 (2017).

    Article 
    PubMed 

    Google Scholar
     

  • Diaz, K. M. & Shimbo, D. Physical activity and the prevention of hypertension. Curr. Hypertens. Rep. 15, 659–668 (2013).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Bruunsgaard, H. Physical activity and modulation of systemic low-level inflammation. J. Leukoc. Biol. 78, 819–835 (2005).

    Article 
    CAS 
    PubMed 

    Google Scholar
     

  • Nimmo, M., Leggate, M., Viana, J. & King, J. The effect of physical activity on mediators of inflammation. Diab. Obes. Metab. 15, 51–60 (2013).

    Article 
    CAS 

    Google Scholar
     

  • Saint-Maurice, P. F. et al. Association of daily step count and step intensity with mortality among US adults. JAMA 323, 1151–1160 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Martin, C. K., Church, T. S., Thompson, A. M., Earnest, C. P. & Blair, S. N. Exercise dose and quality of life: a randomized controlled trial. Arch. Intern. Med. 169, 269–278 (2009).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Patterson, R. et al. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur. J. Epidemiol. 33, 811–829 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Beunza, J. J. et al. Sedentary behaviors and the risk of incident hypertension: the SUN Cohort. Am. J. Hypertens. 20, 1156–1162 (2007).

    PubMed 

    Google Scholar
     

  • Biddle, S. J. & Asare, M. Physical activity and mental health in children and adolescents: a review of reviews. Br. J. Sports Med. 45, 886–895 (2011).

    Article 
    PubMed 

    Google Scholar
     

  • VanKim, N. A. & Nelson, T. F. Vigorous physical activity, mental health, perceived stress, and socializing among college students. Am. J. Health Promot. 28, 7–15 (2013).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Master, H. et al. Association of step counts over time with the risk of chronic disease in the All of Us Research Program. Nat. Med. 28, 2301–2308 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Paluch, A. E. et al. Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. Lancet Public Health 7, e219–e228 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Guthold, R., Stevens, G. A., Riley, L. M. & Bull, F. C. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob. Health 6, e1077–e1086 (2018).

    Article 
    PubMed 

    Google Scholar
     

  • Kryger, M. H., Roth, T. & Dement, W. C. Principles and Practice of Sleep Medicine-E-Book: Expert Consult-Online and Print (Elsevier Health Sciences, 2010).

  • Grandner, M. A. Sleep, health, and society. Sleep. Med. Clin. 17, 117–139 (2022).

    Article 
    PubMed 

    Google Scholar
     

  • Stickgold, R. Sleep-dependent memory consolidation. Nature 437, 1272–1278 (2005).

    Article 
    CAS 
    PubMed 

    Google Scholar
     

  • Walker, M. P. & Stickgold, R. Sleep-dependent learning and memory consolidation. Neuron 44, 121–133 (2004).

    Article 
    CAS 
    PubMed 

    Google Scholar
     

  • Van Dongen, H. P., Maislin, G., Mullington, J. M. & Dinges, D. F. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 26, 117–126 (2003).

    Article 
    PubMed 

    Google Scholar
     

  • Morselli, L., Leproult, R., Balbo, M. & Spiegel, K. Role of sleep duration in the regulation of glucose metabolism and appetite. Best. Pract. Res. Clin. Endocrinol. Metab. 24, 687–702 (2010).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Dattilo, M. et al. Sleep and muscle recovery: endocrinological and molecular basis for a new and promising hypothesis. Med. Hypotheses 77, 220–222 (2011).

    Article 
    CAS 
    PubMed 

    Google Scholar
     

  • Takahashi, Y., Kipnis, D. & Daughaday, W. Growth hormone secretion during sleep. J. Clin. Investig. 47, 2079–2090 (1968).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Banks, S. & Dinges, D. F. Behavioral and physiological consequences of sleep restriction. J. Clin. Sleep. Med. 3, 519–528 (2007).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Faraut, B., Boudjeltia, K. Z., Vanhamme, L. & Kerkhofs, M. Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep. Med. Rev. 16, 137–149 (2012).

    Article 
    PubMed 

    Google Scholar
     

  • Bubu, O. M. et al. Sleep, cognitive impairment, and Alzheimer’s disease: a systematic review and meta-analysis. Sleep 40, zsw032 (2017).

    Article 

    Google Scholar
     

  • Scott, A. J., Webb, T. L., Martyn-St James, M., Rowse, G. & Weich, S. Improving sleep quality leads to better mental health: a meta-analysis of randomised controlled trials. Sleep. Med. Rev. 60, 101556 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Baglioni, C. et al. Sleep and mental disorders: a meta-analysis of polysomnographic research. Psychol. Bull. 142, 969 (2016).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Chaput, J.-P. et al. The role of insufficient sleep and circadian misalignment in obesity. Nat. Rev. Endocrinol. 19, 82–97 (2023).

    Article 
    CAS 
    PubMed 

    Google Scholar
     

  • Calhoun, D. A. & Harding, S. M. Sleep and hypertension. Chest 138, 434–443 (2010).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Mullington, J. M., Simpson, N. S., Meier-Ewert, H. K. & Haack, M. Sleep loss and inflammation. Best. Pract. Res. Clin. Endocrinol. Metab. 24, 775–784 (2010).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Irwin, M. R., Olmstead, R. & Carroll, J. E. Sleep disturbance, sleep duration, and inflammation: a systematic review and meta-analysis of cohort studies and experimental sleep deprivation. Biol. Psychiatry 80, 40–52 (2016).

    Article 
    PubMed 

    Google Scholar
     

  • Gallicchio, L. & Kalesan, B. Sleep duration and mortality: a systematic review and meta-analysis. J. Sleep. Res. 18, 148–158 (2009).

    Article 
    PubMed 

    Google Scholar
     

  • Cappuccio, F. P., D’Elia, L., Strazzullo, P. & Miller, M. A. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 33, 585–592 (2010).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Kripke, D. F., Garfinkel, L., Wingard, D. L., Klauber, M. R. & Marler, M. R. Mortality associated with sleep duration and insomnia. Arch. Gen. Psychiatry 59, 131–136 (2002).

    Article 
    PubMed 

    Google Scholar
     

  • Hirshkowitz, M. et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep. Health 1, 40–43 (2015).

    Article 
    PubMed 

    Google Scholar
     

  • Oftedal, S. et al. Prevalence, trends, and correlates of joint patterns of aerobic and muscle-strengthening activity and sleep duration: a pooled analysis of 359,019 adults in the National Health Interview Survey 2004–2018. J. Phys. Act. Health 19, 246–255 (2022).

    Article 
    PubMed 

    Google Scholar
     

  • Dolezal, B. A., Neufeld, E. V., Boland, D. M., Martin, J. L. & Cooper, C. B. Interrelationship between sleep and exercise: a systematic review. Adv. Prevent. Med. 2017, 1364387 (2017).


    Google Scholar
     

  • Wang, F. & Boros, S. The effect of physical activity on sleep quality: a systematic review. Eur. J. Physiother. 23, 11–18 (2021).

    Article 
    CAS 

    Google Scholar
     

  • Gubelmann, C., Heinzer, R., Haba-Rubio, J., Vollenweider, P. & Marques-Vidal, P. Physical activity is associated with higher sleep efficiency in the general population: the CoLaus study. Sleep 41, zsy070 (2018).

    Article 

    Google Scholar
     

  • Foti, K. E., Eaton, D. K., Lowry, R. & McKnight-Ely, L. R. Sufficient sleep, physical activity, and sedentary behaviors. Am. J. Prevent. Med. 41, 596–602 (2011).

    Article 

    Google Scholar
     

  • Koohsari, M. J. et al. Sedentary behaviour and sleep quality. Sci. Rep. 13, 1180 (2023).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Chennaoui, M., Arnal, P. J., Sauvet, F. & Léger, D. Sleep and exercise: a reciprocal issue? Sleep. Med. Rev. 20, 59–72 (2015).

    Article 
    PubMed 

    Google Scholar
     

  • Seol, J. et al. Bidirectional associations between physical activity and sleep in older adults: a multilevel analysis using polysomnography. Sci. Rep. 12, 15399 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Zhao, H., Lu, C. & Yi, C. Physical activity and sleep quality association in different populations: a meta-analysis. Int. J. Environ. Res. Public Health 20, 1864 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Alnawwar, M. A. et al. The effect of physical activity on sleep quality and sleep disorder: a systematic review. Cureus 15, e43595 (2023).

  • Zapalac, K., Miller, M., Champagne, F. A., Schnyer, D. M. & Baird, B. The effects of physical activity on sleep architecture and mood in naturalistic environments. Sci. Rep. 14, 5637 (2024).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Rosenberger, M. E. et al. The 24-hour activity cycle: a new paradigm for physical activity. Med. Sci. Sports Exerc. 51, 454 (2019).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Pedišić, Ž Measurement issues and poor adjustments for physical activity and sleep undermine sedentary behaviour research—the focus should shift to the balance between sleep, sedentary behaviour, standing and activity. Kinesiology 46, 135–146 (2014).


    Google Scholar
     

  • Chastin, S. F., Palarea-Albaladejo, J., Dontje, M. L. & Skelton, D. A. Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: a novel compositional data analysis approach. PloS One 10, e0139984 (2015).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • World Health Organization. Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 years of Age 36-36 (WHO, 2019).

  • Okely, A. D. et al. A collaborative approach to adopting/adapting guidelines-The Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): an integration of physical activity, sedentary behavior, and sleep. BMC Public Health 17, 167–190 (2017).

    Article 

    Google Scholar
     

  • Ross, R. et al. Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Appl. Physiol. Nutr. Metab. 45, S57–S102 (2020).

    Article 
    PubMed 

    Google Scholar
     

  • Rollo, S., Antsygina, O. & Tremblay, M. S. The whole day matters: understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan. J. Sport Health Sci. 9, 493–510 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • McDonald, S. et al. Changes in physical activity during the retirement transition: a series of novel n-of-1 natural experiments. Int. J. Behav. Nutr. Phys. Act. 14, 1–12 (2017).

    Article 

    Google Scholar
     

  • Gabriel, K. P. et al. Bidirectional associations of accelerometer-determined sedentary behavior and physical activity with reported time in bed: Women’s Health Study. Sleep. Health 3, 49–55 (2017).

    Article 

    Google Scholar
     

  • Cunningham, C., O’Sullivan, R., Caserotti, P. & Tully, M. A. Consequences of physical inactivity in older adults: a systematic review of reviews and meta-analyses. Scand. J. Med. Sci. Sports 30, 816–827 (2020).

    Article 
    PubMed 

    Google Scholar
     

  • Angulo, J., El Assar, M., Álvarez-Bustos, A. & Rodríguez-Mañas, L. Physical activity and exercise: strategies to manage frailty. Redox Biol. 35, 101513 (2020).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Edouard, P. et al. Validation of the Withings Sleep Analyzer, an under-the-mattress device for the detection of moderate-severe sleep apnea syndrome. J. Clin. Sleep. Med. 17, 1217–1227 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Mendelson, M. et al. Obstructive sleep apnea syndrome, objectively measured physical activity and exercise training interventions: a systematic review and meta-analysis. Front. Neurol. 9, 73 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Frangopoulos, F. et al. The complex interaction between the major sleep symptoms, the severity of obstructive sleep apnea, and sleep quality. Front. Psychiatry 12, 630162 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Haghayegh, S., Khoshnevis, S., Smolensky, M. H., Diller, K. R. & Castriotta, R. J. Accuracy of wristband Fitbit models in assessing sleep: systematic review and meta-analysis. J. Med. Internet Res. 21, e16273 (2019).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Chee, N. I. et al. Multi-night validation of a sleep tracking ring in adolescents compared with a research actigraph and polysomnography. Nat. Sci. Sleep. 13, 177–190 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Scott, H. et al. Sleep irregularity is associated with hypertension: findings from over 2 million nights with a large global population sample. Hypertension 80, 1117–1126 (2023).

    Article 
    CAS 
    PubMed 

    Google Scholar
     

  • Lee, T. et al. Accuracy of 11 wearable, nearable, and airable consumer sleep trackers: prospective multicenter validation study. JMIR mHealth uHealth 11, e50983 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Manners, J. et al. Performance evaluation of an under-mattress sleep sensor versus polysomnography in ≥400 nights with healthy and unhealthy sleep. J. Sleep Res. 34, e14480 (2025).

  • Dominici, F. et al. Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA 295, 1127–1134 (2006).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Mundo, A. I., Tipton, J. R. & Muldoon, T. J. Generalized additive models to analyze nonlinear trends in biomedical longitudinal data using R: Beyond repeated measures ANOVA and linear mixed models. Stat. Med. 41, 4266–4283 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Wood, S. N. Generalized Additive Models: An Introduction with R. (Chapman and Hall/CRC, 2017).

  • van Oostrom, S. H., Nooyens, A. C., van Boxtel, M. P. & Verschuren, W. M. Long sleep duration is associated with lower cognitive function among middle-age adults–the Doetinchem Cohort Study. Sleep. Med. 41, 78–85 (2018).

    Article 
    PubMed 

    Google Scholar
     

  • Ma, Y. et al. Association between sleep duration and cognitive decline. JAMA Netw. open 3, e2013573–e2013573 (2020).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • You, Y. et al. Inverted U-shaped relationship between sleep duration and phenotypic age in US adults: a population-based study. Sci. Rep. 14, 6247 (2024).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Coutrot, A. et al. Reported sleep duration reveals segmentation of the adult life-course into three phases. Nat. Commun. 13, 7697 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Tudor-Locke, C., Craig, C. L., Thyfault, J. P. & Spence, J. C. A step-defined sedentary lifestyle index:Appl. Physiol. Nutr., Metab. 38, 100–114 (2013).

    Article 
    PubMed 

    Google Scholar
     

  • Paluch, A. E. et al. Steps per day and all-cause mortality in middle-aged adults in the coronary artery risk development in young adults study. JAMA Netw. Open 4, e2124516–e2124516 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Paluch, A. E. et al. Prospective association of daily steps with cardiovascular disease: a harmonized meta-analysis. Circulation 147, 122–131 (2023).

    Article 
    PubMed 

    Google Scholar
     

  • Allaire, J. et al. Package ‘networkD3’. D3 JavaScript network graphs from R (2017).

  • Team, R. C. R: A Language and Environment for Statistical Computing (R Foundation for Statistical Computing, 2013).

  • Shields, M. & Tremblay, M. S. Sedentary behaviour and obesity. Health Rep. 19, 19–30 (2008).

    PubMed 

    Google Scholar
     

  • Mahumud, R. A. et al. Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries. Int J. Obes. 45, 2404–2418 (2021).

    Article 

    Google Scholar
     

  • Silveira, E. A. et al. Sedentary behavior, physical inactivity, abdominal obesity and obesity in adults and older adults: a systematic review and meta-analysis. Clin. Nutr. ESPEN 50, 63–73 (2022).

    Article 
    PubMed 

    Google Scholar
     

  • Tison, G. H. et al. Worldwide physical activity trends since COVID-19 onset. Lancet Glob. Health 10, e1381–e1382 (2022).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • McCarthy, H., Potts, H. W. & Fisher, A. Physical activity behavior before, during, and after COVID-19 restrictions: longitudinal smartphone-tracking study of adults in the United Kingdom. J. Med. Internet Res. 23, e23701 (2021).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Tison, G. H. et al. Worldwide effect of COVID-19 on physical activity: a descriptive study. Ann. Intern. Med. 173, 767–770 (2020).

    Article 
    PubMed 

    Google Scholar
     

  • Schepps, M. A., Shiroma, E. J., Kamada, M., Harris, T. B. & Lee, I.-M. Day length is associated with physical activity and sedentary behavior among older women. Sci. Rep. 8, 6602 (2018).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Choi, B. C., Pak, A. W., Choi, J. C. & Choi, E. C. Daily step goal of 10,000 steps: a literature review. Clin. Invest. Med. 30, E146–E151 (2007).

    Article 
    PubMed 

    Google Scholar
     

  • Inoue, K., Tsugawa, Y., Mayeda, E. R. & Ritz, B. Association of daily step patterns with mortality in US adults. JAMA Netw. Open 6, e235174 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Vanderlinden, J., Boen, F. & Van Uffelen, J. Effects of physical activity programs on sleep outcomes in older adults: a systematic review. Int. J. Behav. Nutr. Phys. Act. 17, 1–15 (2020).

    Article 

    Google Scholar
     

  • Atoui, S. et al. Daily associations between sleep and physical activity: A systematic review and meta-analysis. Sleep. Med. Rev. 57, 101426–101426 (2021).

    Article 
    PubMed 

    Google Scholar
     

  • Leota, J. et al. Dose-response relationship between evening exercise and sleep. Nat. Commun. 16, 3297 (2025).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Ferguson, T. et al. Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. Lancet Digital Health 4, e615–e626 (2022).

    Article 
    CAS 
    PubMed 

    Google Scholar
     

  • Doherty, C., Baldwin, M., Lambe, R., Burke, D. & Altini, M. Readiness, recovery, and strain: an evaluation of composite health scores in consumer wearables. Transl. Exerc. Biomed. 2, 128–144 (2025).

  • Baldursdottir, B., Taehtinen, R. E., Sigfusdottir, I. D., Krettek, A. & Valdimarsdottir, H. B. Impact of a physical activity intervention on adolescents’ subjective sleep quality: a pilot study. Glob. Health Promot. 24, 14–22 (2017).

    Article 
    PubMed 

    Google Scholar
     

  • Lim, D. C. et al. The need to promote sleep health in public health agendas across the globe. Lancet Public Health 8, e820–e826 (2023).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Althoff, T. et al. Large-scale physical activity data reveal worldwide activity inequality. Nature 547, 336–339 (2017).

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Westcott, W. L. Resistance training is medicine: effects of strength training on health. Curr. Sports Med. Rep. 11, 209–216 (2012).

    Article 
    PubMed 

    Google Scholar
     

  • de Havenon, A. et al. Impact of sleep quality and physical activity on blood pressure variability. Plos One 19, e0301631 (2024).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar
     

  • Lloyd-Jones, D. M. et al. Life’s essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation 146, e18–e43 (2022).

    Article 
    PubMed 
    PubMed Central 

    Google Scholar