Sleep duration has a well-established effect on mental health and well-being, with durations of 7 to 9 hours being the general recommendation. Here, we analyze the significance of sleep patterns and find that a consistent routine reduces the risk of developing mental disorders far more than simply ensuring a certain average sleep duration.
We analyzed the sleep behavior of 100,000 adults for one week using motion data from wrist-worn devices. We modeled sleep behavior using multivariate generalized additive Cox proportional hazard models, incorporating a smooth 2D interaction effect of sleep duration and routine sleep hours. We calculated C-statistics and E-values to evaluate model performance and assess the robustness against hidden confounders. We also stratified analyses by age and gender.
Most participants slept for 7 to 9 hours as recommended, yet they consistently only slept during the same 4.8 hours each night. We found that an average sleep duration around 8 hours minimizes the risk of future mental disorders—but only if integrated into a rigorous sleep routine spanning at least the same 7 hours each night. Our study provides evidence that adopting such sleep behavior could reduce the population incidence rate of mental disorders by 23% (HR: 0.79, \(p0.0001\), for the average participant). The models showed a strong fit (C-statistics: 0.63), robustness to hidden confounders (E-value: 1.8), and stability under age-and gender-based stratification. We identified weekend behavior as a frequent reason for low sleep routines, with over 25% of the population disrupting their weekly sleep routine during weekend nights—raising the risk of future mental disorders by 10%.
