Abstract
Objectives
To identify the sleep duration associated with the lowest cardiometabolic risk score
in adults and to determine if the association varies by subgroups (eg, sex, age groups,
ethnicity, and smoking status).
Design
Cross-sectional data from the 2005–2012 National Health and Nutrition Examination
Survey.
Setting
Non-institutionalized civil sample from the United States.
Participants
Age ≥20 y (N = 8827) with sleep and cardiometabolic health data.
Interventions
N/A.
Measurements
Sleep duration from the Sleep Disorders Questionnaire was categorized as ≤3, 4, 5,
6, 7, 8, 9, and ≥10 h per night. HDL cholesterol (HDL) and waist circumference (WC)
were stratified by sex first, while fasting insulin, fasting plasma glucose (Glu),
triglycerides (TG), body max index (BMI), systolic blood pressure (SBP) and diastolic
blood pressure (DBP) were standardized without stratifications. The standardized scores
were summed for each participant using the following formula: −zHDL + zInsulin + zGlu
+ zTG + (zBMI + zWC)/2 + (zSBP + zDBP)/2.
Results
Seven hours of sleep was associated with the lowest cardiometabolic risk score (−0.30
(95% CI: −0.43, −0.18)), which remained similar after adjusting for age, sex, ethnicity,
education, family income, alcohol intake and smoking status. However, 8 hours of sleep
was associated with the lowest score in non-Hispanic Blacks.
Conclusions
This study supports recent sleep duration recommendations in adults, and provides
evidence that in general 7 hours of sleep per night is associated with optimal cardiometabolic
health of adults. Longitudinal studies using objective measures of sleep would help
further clarify this association.
Keywords
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References
- National Sleep Foundation's sleep time duration recommendations: methodology and results summary.Sleep Health. 2015; 1: 40-43https://doi.org/10.1016/j.sleh.2014.12.010
- Social jetlag: misalignment of biological and social time.Chronobiol Int. 2006; 23: 497-509https://doi.org/10.1080/07420520500545979
- Work-family conflict, cardiometabolic risk, and sleep duration in nursing employees.J Occup Health Psychol. 2015; 20: 420-433https://doi.org/10.1037/a0039143
- Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies.Eur Heart J. 2011; 32: 1484-1492
- Meta-analysis of short sleep duration and obesity in children and adults.Sleep. 2008; 31: 619-626
- Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis.Diabetes Care. 2010; 33: 414-420https://doi.org/10.2337/dc09-1124
- Association of usual sleep duration with hypertension: the sleep heart health study.Sleep. 2006; 29: 1009
- Associations between sleep loss and increased risk of obesity and diabetes.Ann N Y Acad Sci. 2008; 1129: 287-304https://doi.org/10.1196/annals.1417.033
- Trends in self-reported sleep duration among US adults from 1985 to 2012.Sleep. 2014; 38: 829-832
- Feature: insufficient sleep is a public health epidemic.([Accessed June 5, 2013])
- Joint consensus statement of the American Academy of sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion.Sleep. 2015; 38: 1161-1183https://doi.org/10.5665/sleep.4886
- Recommended amount of sleep for a healthy adult: a Joint consensus statement of the American Academy of sleep Medicine and Sleep Research Society.Sleep. 2015; 38: 843-844https://doi.org/10.5665/sleep.4716
- Seven to eight hours of sleep a night is associated with a lower prevalence of the metabolic syndrome and reduced overall Cardiometabolic risk in adults.PLoS One. 2013; 8: e72832https://doi.org/10.1371/journal.pone.0072832
- Sleep duration and metabolic syndrome in adult populations: a meta-analysis of observational studies.Nutr Diabetes. 2013; 3: e65https://doi.org/10.1038/nutd.2013.8
- Short sleep duration predicts risk of metabolic syndrome: a systematic review and meta-analysis.Sleep Med Rev. 2014; 18: 293-297
- Harmonizing the metabolic syndrome a Joint interim statement of the International diabetes federation task force on epidemiology and prevention; National Heart, Lung, and Blood Institute; American Heart Association; world heart federation; International atherosclerosis society; and International Association for the Study of obesity.Circulation. 2009; 120: 1640-1645https://doi.org/10.1161/circulationaha.109.192644
- Habitual sleep duration associated with self-reported and objectively-determined Cardiometabolic risk factors.Sleep Med. 2014; 15: 42-50https://doi.org/10.1016/j.sleep.2013.09.012
- U-shaped association of sleep duration with metabolic syndrome and insulin resistance in patients with type 2 diabetes: the Fukuoka diabetes registry.Metabolism. 2014; 63: 484-491https://doi.org/10.1016/j.metabol.2013.12.001
- Sleep duration among adults aged ≥20 years, by race/ethnicity — National Health and Nutrition examination Survey, United States, 2007–2010.62. 2013: 755
- Extreme sleep durations and increased C-reactive protein: effects of sex and Ethnoracial group.Sleep. 2013; 36: 769-779https://doi.org/10.5665/sleep.2646
- The relationship between sleep duration and body mass index depends on age.Obesity (Silver Spring). 2015; 23: 2491-2498https://doi.org/10.1002/oby.21247
- Race/ethnicity, sleep duration, and diabetes mellitus: analysis of the National Health Interview Survey.Am J Med. 2012; 125: 162-167https://doi.org/10.1016/j.amjmed.2011.08.020
- Unequal burden of sleep-related obesity among black and white Americans.Sleep Health. 2015; 1: 169-176https://doi.org/10.1016/j.sleh.2015.07.003
- Association of Sleep Duration and Hypertension among US adults varies by age and sex.Am J Hypertens. 2012; 25: 335-341https://doi.org/10.1038/ajh.2011.201
- Number of components of the metabolic syndrome; smoking and inflammatory markers.Int J Endocrinol Metab. 2013; 11: 23-26https://doi.org/10.5812/ijem.8403
- NHANES - about the National Health and Nutrition examination Survey.([Published 2011. Accessed December 27, 2013])
- Association of Sleep-Related Problems with CKD in the United States, 2005-2008.Am J Kidney Dis. 2011; 58: 554-564https://doi.org/10.1053/j.ajkd.2011.05.024
- Validation of continuous clinical indices of cardiometabolic risk in a cohort of Australian adults.BMC Cardiovasc Disord. 2014; 14: 27https://doi.org/10.1186/1471-2261-14-27
- Dietary guidelines for Americans.([Accessed January 3, 2016])
- Common variants in DRD2 are associated with sleep duration: the CARe consortium.Hum Mol Genet. 2016; 25: 167-179https://doi.org/10.1093/hmg/ddv434
- Sleep and society: an epidemiological perspective.Sleep Med. 2009; 10: S3-S6https://doi.org/10.1016/j.sleep.2009.07.005
- Racial/ethnic disparities in sleep health and health care: importance of the sociocultural context.Sleep Health. 2015; 1: 28-35https://doi.org/10.1016/j.sleh.2014.12.004
- On the relationship between individual and population health.Med Health Care Philos. 2009; 12: 235https://doi.org/10.1007/s11019-008-9173-8
- Is sleep duration related to obesity? A critical review of the epidemiological evidence.Sleep Med Rev. 2008; 12: 289-298
- Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US.J Diabetes. 2010; 2: 180-193https://doi.org/10.1111/j.1753-0407.2010.00078.x
- Association between sleep and blood pressure in midlife: the CARDIA sleep study.Arch Intern Med. 2009; 169: 1055-1061
- The metabolic syndrome: prevalence in worldwide populations.Endocrinol Metab Clin North Am. 2004; 33: 351
- Do women exhibit greater differences in established and novel risk factors between diabetes and non-diabetes than men? The British regional heart study and British Women's heart health study.Diabetologia. 2011; 55: 80-87https://doi.org/10.1007/s00125-011-2284-4
- Oxidants, oxidative stress and the biology of ageing.Nature. 2000; 408: 239-247https://doi.org/10.1038/35041687
- Sleeping well, aging well: a descriptive and cross-sectional study of sleep in “successful agers” 75 and older.Am J Geriatr Psychiatry. 2008; 16: 74-82https://doi.org/10.1097/JGP.0b013e3181557b69
- Short and long sleep duration associated with race/ethnicity, Sociodemographics, and socioeconomic position.Sleep. 2014; 37: 601-611https://doi.org/10.5665/sleep.3508
- African genetic ancestry is associated with sleep depth in older African Americans.Sleep. 2015; 38: 1185-1193https://doi.org/10.5665/sleep.4888
- Why are there race/ethnic differences in adult body mass index-adiposity relationships? A quantitative critical review: BMI and race/ethnicity.Obes Rev. 2016; 17: 262-275https://doi.org/10.1111/obr.12358
- Abdominal obesity and metabolic syndrome.Nature. 2006; 444: 881-887
- Waist circumference and weight following smoking cessation in a general population: the Inter99 study.Prev Med. 2007; 44: 290-295https://doi.org/10.1016/j.ypmed.2006.11.015
- A continuous metabolic syndrome risk score.Diabetes Care. 2006; 29: 2329https://doi.org/10.2337/dc06-1341
- Volume, patterns, and types of sedentary behavior and cardio-metabolic health in children and adolescents: a cross-sectional study.BMC Public Health. 2011; 11: 274https://doi.org/10.1186/1471-2458-11-274
- Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester epidemiology project.Mayo Clin Proc. 2012; 87: 151-160https://doi.org/10.1016/j.mayocp.2011.11.009
Article info
Publication history
Published online: April 23, 2017
Accepted:
March 20,
2017
Received in revised form:
February 17,
2017
Received:
January 7,
2016
Identification
Copyright
© 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
