Sleep Habits and Pneumonia Risk: A Study

Short sleep has been linked to more chest and other respiratory infections. Most of that research looks at one sleep habit at a time.

A study published in April 2026 scored five sleep habits together in 361,589 UK adults and followed them for about 13 years. Those with the healthiest scores had about a 26% lower risk of pneumonia.

Who was in the study?

• 361,589 adults from the UK Biobank, recruited between 2006 and 2010 at ages 40 to 69.
• Their average age was 56, and 54% were women.
• 91% were white.
• People with cancer, an organ transplant, a weakened immune system or on steroid tablets at the start were left out.

How did they score sleep?

Everyone answered five questions about their sleep, once, when they joined. Each healthy answer scored 1 point, for a total of 0 to 5:

• Sleeping 7 to 8 hours a day, naps included.
• Being a morning person rather than an evening person.
• Not usually having trouble getting to sleep or staying asleep.
• No partner, relative or friend complaining about your snoring.
• Not often dozing off in the day without meaning to.

Scores of 4 or 5 counted as healthy (58.5% of people), 2 or 3 as intermediate (39.1%), and 0 or 1 as poor (2.3%).

What did it find?

Over a median of 13.2 years, 20,116 people (5.6%) had pneumonia recorded in their GP, hospital or death records, or reported it at a later visit.

• Within 10 years, 5.6% of the poor group had pneumonia on record, against 3.7% of the intermediate group and 2.8% of the healthy group.
• After adjusting for age, sex, ethnicity, deprivation, education, BMI, smoking, alcohol, exercise, diet, COPD, asthma and other long-term conditions, the healthy group had a 26% lower risk than the poor group (hazard ratio 0.74).
• The intermediate group had a 17% lower risk (hazard ratio 0.83).
• Risk went down step by step as the score went up.

The healthy group also had a lower risk of bacterial pneumonia (hazard ratio 0.60), viral pneumonia (0.70), other chest infections (0.81) and respiratory failure (0.73).

Which habits mattered on their own?

Each habit was tested in its own model, without adjusting for the other four, so the authors call these descriptive, not separate effects. The other adjustments were the same, except that BMI was left out of the snoring model.

• No frequent daytime sleepiness: 21% lower risk (hazard ratio 0.79).
• No frequent insomnia: 12% lower (0.88).
• Morning person: 7% lower (0.93).
• Sleep length: against 7 to 8 hours, under 7 hours went with a 15% higher risk (1.15) and over 8 hours with a 29% higher risk (1.29).
• Snoring: no significant link (hazard ratio 1.00).

So where does snoring fit?

Snoring was in the score as a rough stand-in for sleep apnea, since the UK Biobank had no sleep studies. On its own, it showed no significant link with pneumonia risk.

The authors point out that other studies have linked sleep apnea itself to pneumonia. But a complaint about snoring can't tell harmless snoring apart from sleep apnea, so this study couldn't test that. For how the two differ, see snoring vs sleep apnea.

A UK Biobank study using the same score found the same pattern for neck disc problems: the other four habits stood out, snoring didn't.

Did it differ between groups?

• The link was stronger in people under 60 and in women. The authors say this needs repeating before reading much into it.
• It held across BMI, smoking, exercise, diet and other long-term conditions.

The result held when they:

• Left out anyone who got a chest problem in the first 2 years (hazard ratio 0.73).
• Used only people with no missing data (hazard ratio 0.75).

What doesn't it tell you?

The authors list these limits:

• Cause. It's an observational study. It shows what went together, not that better sleep protects you from pneumonia. The authors say whether changing sleep habits lowers pneumonia risk is unknown.
• One snapshot. Sleep was self-reported once, at the start, with no sleep trackers. Changes over 13 years weren't captured.
• Vaccines. Flu and pneumonia vaccine records weren't available, so they couldn't be adjusted for.
• Other factors. Other unmeasured differences between the groups could explain part of the link.
• The score. All five habits counted equally, and sleep quality and regularity weren't measured.
• Who it applies to. Mostly white UK volunteers aged 40 to 69, and few people had poor scores.

The study was funded by Peking University People's Hospital, and the authors declare no conflicts of interest.

What can you do with this?

These are our suggestions, not the study's findings.

• If you snore and also feel exhausted in the day, the sleep apnea risk check helps you decide whether to talk to a doctor.
• An overnight oximeter doesn't record snoring, insomnia or how sleepy you feel. It records your oxygen and pulse through the night, which you can share with your doctor.
• To see what it can and can't add, read is an overnight pulse oximeter worth it?

Not a medical device. Does not diagnose, treat or prevent any condition. Discuss results and changes with a clinician.

References

1. Fu X, Li X, Gao Y, Wu N, Ao T, Ni W. Multidimensional healthy sleep characteristics and pneumonia risk: a large-scale, population-based prospective cohort study. Open Forum Infectious Diseases. 2026;13(5):ofag233. doi:10.1093/ofid/ofag233