Blunted rest-activity circadian rhythm increases the risk of all-cause, cardiovascular disease and cancer mortality in US adults.

To examine whether rest-activity circadian rhythm parameters can predict all-cause, cardiovascular disease and cancer mortality in a general adult population of the US. We further compared the mortality predictive performance of these parameters with that of traditional risk factors. This study included 7,252 adults from US National Health and Nutrition Examination Surveys (NHANES) 2011-2014, who had wrist accelerometer data obtained at baseline and follow-up status linked to the National Death Index records (2011-2019). During a median of 81 months (interquartile range, 69-94 months) of follow-up, 674 (9.3%) deaths occurred. There were inverse associations between relative amplitude (RA) and all-cause mortality, cardiovascular disease and cancer mortality with increased quartiles RA associated with lower mortality risk (all P < 0.05). The Hazard Ratios ranged from 0.61 to 0.79. Furthermore, RA outperformed all the tested traditional predictors of all-cause mortality with the exception of age. This study suggests that participants with blunted rest-activity circadian rhythms had a higher risk of all-cause, cardiovascular disease and cancer mortality. Future studies will be needed to test whether interventions that regulate rest-activity circadian activity rhythms will improve health outcomes.