Abstract / Summary
Introduction The longitudinal association between sleep behaviors and the incidence of various thyroid diseases remains unclear. This study aimed to prospectively investigate the association between a healthy sleep score and the risk of incident thyroid diseases using data from the UK Biobank. Methods This prospective cohort study included 499, 084 adults aged 37–73 years from the UK Biobank. A healthy sleep score ranging from 0 to 5 was constructed based on five self-reported sleep behaviors: chronotype, sleep duration, insomnia, snoring, and daytime excessive sleepiness. Participants with missing information on sleep behaviors were excluded from the construction of the healthy sleep score. Incident outcomes included overall thyroid disease, hypothyroidism, nontoxic goiter, thyrotoxicosis, thyroiditis, thyroid cancer, and iodine deficiency–related diseases. Results After adjustment for multiple covariates, higher healthy sleep scores were dose-dependently associated with lower risks of overall thyroid disease, hypothyroidism, nontoxic goiter, and thyrotoxicosis. Compared with participants with poor sleep patterns (scores of 0–1), those with the healthiest sleep pattern (score of 5) had significantly lower risks of overall thyroid disease (24% [17%–31%]), hypothyroidism (25% [17%–32%]), nontoxic goiter (26% [7%–41%]), and thyrotoxicosis (32% [15%–45%]). Among the five sleep components, the absence of frequent daytime excessive sleepiness showed a particularly evident association with lower risks of thyroid disease. Furthermore, interaction analyses suggested that the inverse association between the healthy sleep score and the risk of overall thyroid disease may vary by sex, BMI, and diabetes status, with more pronounced associations observed among women, individuals with obesity, and those without diabetes. Conclusion Higher healthy sleep scores were associated with lower risks of incident overall thyroid disease, hypothyroidism, nontoxic goiter, and thyrotoxicosis. Among the individual sleep components, the absence of frequent daytime excessive sleepiness showed the strongest association with a lower risk of thyroid disease.