Sleep and circadian health in the UK Biobank: Report on the 2023 sleep questionnaire enhancement.

STUDY OBJECTIVES: Our study introduced the 2023 UK Biobank sleep questionnaire and described variation in sleep health dimensions and prevalence of disordered sleep. METHODS: A questionnaire comprising validated measures and bespoke items was developed to capture key self-reported domains of sleep health and symptoms of sleep disorders. We quantified cohort prevalence of operationally defined sleep disorders and assessed patterning of sleep health dimensions across key sociodemographic and clinically relevant variables. RESULTS: 183,704 individuals completed at least one module of the questionnaire after email invitation (representing 56% of those with an active email address), and an additional 1,352 individuals completed via the participant website. A total of 185,056 individuals were included in the analysis. Respondents were predominately from a White ethnic background (96.8%), had a mean age of 69.9 (SD, 7.5) years, 57.9% were female, and 25.5% were in employment. Compared to non-respondents, respondents were more likely to be female, tended to be better educated, healthier, and exhibit lower levels of socioeconomic deprivation, although baseline sleep variables were similar between respondents and non-respondents. Around 40% of respondents reported sleep duration less than 7 hours and 49% reported poor sleep quality (Pittsburgh Sleep Quality Index > 5). Approximately one-quarter (25.2%) met criteria for at least one operationally defined sleep disorder, with insomnia being the most common (14.4%) followed by obstructive sleep apnoea (8.0%), restless legs syndrome (4.1%), and frequent nightmares (3.7%). Sleep disorders were associated with higher levels of anxiety, depression, fatigue, and cognitive complaints. CONCLUSIONS: Poor sleep quality and operationally defined sleep disorders are common in the UK Biobank cohort. Sleep questionnaire data can now be integrated with a range of biomedical information to advance understanding of sleep. Statement of significance A comprehensive sleep questionnaire was introduced to the UK Biobank, with over 185,000 participants providing data. Overall, respondents reported relatively poor sleep quality; 40% reported sleep duration less than 7 hours, and 25% met criteria for at least one sleep disorder. Enhanced assessment of sleep in UK Biobank now enables integration with extensive biomedical data, including genetic, wearable, imaging, lifestyle, biomarker, and electronic health record data, offering opportunities to investigate the biological and environmental factors that influence sleep and circadian systems, and their impact on health.