Habitual Sleep Duration Associated With Self-Reported and Objectively Determined Cardiometabolic Risk Factors

Study Questions:

Do adults with long and short sleep duration, relative to normal sleep duration, increase their cardiometabolic risk?


Data from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) were examined. The self-reported data were supplemented with physical exam data obtained in mobile medical facilities. Sleep duration was characterized as very short (<5 hours), short (5–6 hours), normal (7–8 hours), or long (≥9 hours). Hypertension was defined as taking medication, verified during examination, or blood pressure >140/90 mm Hg. Similarly, hyperlipidemia was verified by compliance with medication, or measurement of lipid level during examination of >240 mg/dl. And diabetes mellitus (DM) was verified by compliance with medication, or measurement of fasting glucose during examination of >125 mg/dl. Covariates and potential confounders were included in the analysis, such as age, ethnicity, socioeconomic factors, and dietary habits including smoking and alcohol use.


Cross-sectional analysis was performed in 5,649 respondents. Very short sleep was associated with self-reported hypertension, hyperlipidemia, objective hyperlipidemia, self-reported DM, and objective obesity. There was no elevated risk associated with long sleepers.


In this cross-sectional survey, the authors concluded that both self-reported and objective sleep duration are associated with hypertension, diabetes, obesity, and hyperlipidemia. The population with the shortest duration of sleep (<5 hours) is at highest risk for these findings and has the most adverse outcomes.


One limitation of epidemiologic self-reported studies was addressed here by combining questionnaires with objective determinations of cardiometabolic risks. The domain with the largest impact was generated by those with short sleep. The short sleepers group is subdivided into groups with 5–6 hours and <5 hours of sleep. The majority of short sleepers are in the 5–6 hours/night group and are likely a heterogeneous group who are less strongly associated with negative outcomes measured in this study. Further studies may identify short sleepers using sleep diaries or concurrent actigraphy to identify adults who may require less sleep and/or are more resilient to sleep loss, relative to cardiometabolic risk.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Hypertension, Smoking

Keywords: Dyslipidemias, Hyperlipidemias, Cross-Sectional Studies, Socioeconomic Factors, Risk Factors, Blood Pressure, Obesity, Hypertension, Diabetes Mellitus, Smoking

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