ESC Congress 2026 Abstract · Oct 26, 2026

Multidimensional sleep health among Chinese adults: a nationwide wearable-based real-world study

By Wang Y, Zhou SS, Liu YQ et al.

Background: The proposed multidimensional framework for sleep health has shifted the focus from sleep duration alone to a more comprehensive assessment of sleep and its physiological relevance. Advances in consumer-grade wearable devices have enabled large-scale, multidimensional sleep monitoring in real-world settings. Purpose: To characterize multidimensional sleep health patterns among Chinese adults using wearable device data. Methods: We analysed data from the Huawei Blood Pressure Health Study (Huawei-BPHS), a nationwide, wearable-based real-world study. Participants enrolled between January 2022 and December 2023 who had at least three consecutive weekdays and three weekend days of valid sleep data were included. Demographic information and medical histories were obtained through electronic questionnaires administered via the Huawei Innovation Research App. Physical activity, psychological stress,blood pressure, sleep, and heart rate were objectively and continuously monitored using Huawei wearable devices. Sleep parameters included night-time sleep duration, number of awakenings, sleep onset timing, daytime sleep duration, deep sleep duration, and sleep stage composition. Results: A total of 205,593 participants from 31 provinces in China were included, contributing 20,705,565 sleep records. The mean age was 39 years, and 68.9% were aged 18–45 years; 89% were men. Mean total sleep duration was 7.3 hours, with mean night-time sleep of 6.8 hours. Only 41.5% of participants achieved the recommended 7–9 hours of night sleep, while 41.6% experienced ≥2 nocturnal awakenings. Sleep onset time was markedly delayed, with 65.9% falling asleep after 23:00. Women slept longer, were less likely to be short sleepers, and had fewer nocturnal awakenings than men. With increasing age, night-time sleep duration increased, sleep onset shifted earlier, and sleep continuity declined substantially. Higher body mass index was associated with shorter sleep duration, later sleep onset, reduced deep sleep, and greater sleep fragmentation (all p for trend <0.001).Marked regional variation was observed, with a clear east–west gradient in sleep onset time(Figure 1. Geographical variation in sleep onset times across the study population). Night sleep duration was consistently longer on weekends and public holidays than on weekdays, and longer in winter than in summer(Figure 2. Visualization of short-term and long-term sleep regularity using a calendar heatmap). Mean sleep duration varied over the one-year observation period, with a clear inflection point around day 97 indicating a shift from longer to shorter sleep duration (mean difference 0.4 h; p < 0.001). Conclusion: By characterizing multidimensional sleep health at the population level, this study identifies marked demographics, regional disparities and time distribution in sleep patterns across China. These findings support the value of wearable-based, multidimensional sleep phenotype for health management .Figure 1Figure 2

doi.org/10.1093/eurheartj/ehag785.4352Open accessPopulations