Fig. 3: Associations of sleep restriction-rebound patterns with all-cause mortality risk.

a Associations in the overall sample. Model 1 was adjusted for age, sex, and ethnicity. Model 2 additionally included employment status, education, BMI, smoking status, alcohol frequency, physical activity, night shift work, and early chronotype. Model 3 further accounted for baseline sleep duration (P values [vs. regular sleep] for SR without rebound, SR with rebound, severe SR without rebound, and severe SR with rebound, respectively: 0.030, 0.090, \(6.98\times {10}^{-7}\), and 0.169). b Associations stratified by baseline sleep duration. Models were adjusted for the same set of covariates as in Model 2 in (a). P values (vs. regular sleep) for SR without rebound, SR with rebound, severe SR without rebound, and severe SR with rebound, respectively: short (0.034, 0.628, \(1.36\times {10}^{-4}\), 0.639), medium (0.716, 0.226, 0.034, and 0.206), and long sleepers (0.564, 0.171, \(1.70\times {10}^{-3}\), 0.378). Cox proportional hazards regression models with two-sided Wald tests were used to estimate HRs for all-cause mortality. Data are presented as HRs with 95% CIs. SR was defined as average cumulative sleep loss of 2.5–3.5 h relative to individual sleep need across restriction periods. Severe SR was defined as average cumulative sleep loss exceeding 3.5 h. Sleep rebound was defined as average extra sleep more than 0 h relative to individual sleep need across post-restriction periods. Baseline sleep duration categories (short/medium/long) were defined based on the tertiles of average baseline sleep duration in 85,618 participants with sleep restriction-rebound patterns. Source data are provided as a Source data file. SR sleep restriction, HR hazard ratio, CI confidence interval, BMI body mass index, P uncorrected P value. *P < 0.05, **P < 0.01, and ***P < 0.001.