As part of the baseline questionnaire, participants reported five sleep characteristics, based on which we further identified five healthy phenotypes, including no usual insomnia complaints, adequate sleep duration (7 to < 9 h/day), no snoring, morning chronotype, and no frequent daytime sleepiness [9 (link)]. We scored participants from 0 to 5, according to the count of healthy characteristics and categorized them into three groups: “healthy sleep” (≥ 4 composite sleep score); “intermediate sleep” (2 or 3 score); and “poor sleep” (≤ 1 score). This categorization has been proven to distinguish different CVD risk profiles, and the simple addition approach showed a similar predictive power to a weighted score [9 (link)]. The original questions and options were provided in Additional file 1 : Table S2. These definitions and scores have shown excellent convergent validity with CVD incidence and mortality [8 (link), 9 (link)].
We identified recent clinical sleep disorder events (2 years before enrolment) based on inpatient admissions, primary care clinical events, and sleep disorder-specific prescriptions (BNF Chapter 4 Sect. 1: hypnotics and anxiolytics). Modified from the definition provided by the American Sleep Association and American Academy of Sleep Medicine [16 , 17 (link)], we distinguished five different sleep disorders, including insomnia, hypersomnia, sleep-related breathing disorders, circadian rhythm sleep disorders, and parasomnias (including sleep-related bruxism). In addition, we grouped hypersomnia, circadian rhythm sleep disorders, parasomnias, non-specific sleep disorders (e.g., “poor sleep pattern”), and sleep medication prescriptions without a corresponding clinical event into “other sleep disorders.” We provided detailed codes for each classification system in Additional file1 : Table S3-5. Since the clinical diagnosis of sleep disorders mainly refers to more than one self-reported sleep characteristic, we did not further integrate both self-reported and clinically unhealthy sleep.
We identified recent clinical sleep disorder events (2 years before enrolment) based on inpatient admissions, primary care clinical events, and sleep disorder-specific prescriptions (BNF Chapter 4 Sect. 1: hypnotics and anxiolytics). Modified from the definition provided by the American Sleep Association and American Academy of Sleep Medicine [16 , 17 (link)], we distinguished five different sleep disorders, including insomnia, hypersomnia, sleep-related breathing disorders, circadian rhythm sleep disorders, and parasomnias (including sleep-related bruxism). In addition, we grouped hypersomnia, circadian rhythm sleep disorders, parasomnias, non-specific sleep disorders (e.g., “poor sleep pattern”), and sleep medication prescriptions without a corresponding clinical event into “other sleep disorders.” We provided detailed codes for each classification system in Additional file
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