Sleep Onset Time and Sleep Duration Associated with Cardiometabolic Health Outcomes 

by Linda Kossoff •

CLINICAL QUESTION

What are the independent and joint associations of sleep onset time and sleep duration with cardiometabolic health outcomes?

BOTTOM LINE

Late sleep onset and insufficient or excessive sleep duration are associated with adverse cardiometabolic outcomes.

BACKGROUND: Cardiometabolic diseases cause an estimated 38 million deaths annually. Factors contributing to cardiometabolic diseases are subject to numerous determinants of health. Although lifestyle behaviors are increasingly recognized as important modifiable risk factors for the prevention and management of cardiometabolic health, their association with sleep onset time and duration is not well characterized.

STUDY DESIGN: Data study

SETTING: Department of Pediatrics, Xinhua Hospital-Shanghai Jiao Tong University School of Medicine, Shanghai, China

SYNOPSIS: Researchers extracted study data from the 2015-2016 and 2017-2018 U.S. National Health and Nutrition Examination Study (NHANES) and gathered sleep onset time and duration data on 6,696 participants (50.8% female; 20-80 years of age) with no cardiovascular disease, cancer, or pregnancy. Sleep duration was categorized as fewer than seven hours, or insufficient (24.1%), seven to eight hours, or sufficient, and more than nine hours, or excessive (20.7%). Sleep onset time was categorized as <22:00, or early (19.8%), 22:00–23:59, or optimal, and >24:00, or late (25.7%). Primary outcomes were hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, central obesity, and metabolic syndrome. Results showed inappropriate sleep onset time and duration were associated with increased odds of hypertension, hypertriglyceridemia, and metabolic syndrome, especially among participants aged 40-59 years. Men reporting optimal onset with excessive duration and late onset with insufficient duration had higher odds of metabolic syndrome. Women reporting optimal onset with insufficient duration and early onset with excessive duration had higher odds of hypertension. Women reporting late onset with excessive duration were at the highest odds of hypertriglyceridemia. No associations were found between sleep parameters and low HDL, hyperglycemia, and central obesity. Study limitations included unmeasured factors, such as shift work and insomnia.

CITATION: Hu P, Vinturache A, Chen Y, et al. Joint association of sleep onset time and sleep duration with cardiometabolic health outcome. J Am Heart Assoc. 2024;13:e034165.