Prevention

4.1 Introduction

Sleep is increasingly recognised as a foundational pillar of longevity science, with mounting evidence linking sleep quality and duration to both healthspan and lifespan. Clinical sleep disorders such as obstructive sleep apnoea, sleep related breathing disorders and sleep related movement disorders are strongly linked with poor health outcomes.

However, there is a continuum of risk, and sub-clinical sleep issues are also linked with poor health outcomes and strongly warrant optimisation to achieve healthy ageing goals. For businesses operating in the sleep and longevity sector, understanding the science behind sleep and its quantifiable impact on health is crucial for developing effective products and services.

The Importance of Sleep in Longevity Science

Sleep plays a critical role in maintaining physiological homeostasis, supporting cognitive function, metabolic health and immune regulation. Disrupted or insufficient sleep has been associated with an increased risk of chronic diseases such as obesity, type 2 diabetes, cardiovascular disease, and neurodegenerative disorders (Walker, 2017), thus reducing lifespan and healthspan.

Epidemiological studies have demonstrated a U-shaped relationship between sleep duration and all-cause mortality, with an increased risk of mortality associated with long sleep duration, especially in women, as well as with short sleep duration, especially in Men (He M et al., 2020) .

The dose-response relationship plot for the association of sleep duration with all-cause mortality. Lines with long dashes represent the pointwise 95% confidence intervals for the fitted nonlinear trend (solid line). Lines with short dashes represent the linear trend. The red horizontal line represents the reference line (hazard ratio: 1)

Mechanisms of Sleep and Ageing

Maintaining healthy sleep habits is important not only for cognitive and metabolic health but also for sustaining a balanced gut microbiome and overall wellbeing (Benedict et al., 2016; Poroyko et al., 2016).

Mechanistically, inadequate sleep exacerbates oxidative stress, impairs glycaemic control, and disrupts circadian rhythms, all of which accelerate biological ageing and increase susceptibility to age-related diseases (Irwin, 2015).

There is a bidirectional relationship between sleep and ageing, whereby ageing itself is associated with changes in circadian rhythms, sleep efficiency, and the prevalence of sleep disorders such as insomnia and sleep apnoea. These alterations can reduce the restorative value of sleep in older adults, making targeted interventions especially important for this demographic (Mander et al., 2017).

Sleep disruption also impairs skin health; inadequate or poor-quality sleep can accelerate visible signs of ageing and compromise the skin’s natural barrier function. When sleep is disrupted, restorative processes, including increased cell turnover and repair of daily environmental damage are hindered, which may lead to increased transepidermal water loss, reduced skin elasticity, and a heightened susceptibility to inflammatory skin conditions such as eczema and psoriasis. In addition, chronic sleep deprivation has been shown to exacerbate oxidative stress, further undermining the skin’s resilience and contributing to premature ageing (Oyetakin-White et al., 2015).

Similarly, there is a bidirectional relationship between sleep and the gut microbiome – disrupted sleep patterns can alter the composition and diversity of gut bacteria possibly through its own circadian rhythm, negatively affecting digestive health, immune function and metabolic regulation. Sleep deprivation has been associated with increased gut permeability—sometimes referred to as ‘leaky gut’—which can trigger systemic inflammation and contribute to the development of chronic diseases.