Abstract
Introduction: Habitual insufficient sleep may contribute to cardiometabolic disease in the United States, particularly among racial and ethnic minorities. However, there is mixed evidence on secular trends in U.S. sleep duration. Therefore, this study investigated annual changes in sleep duration, including variations across demographics and how sleep duration was associated with prevalent cardiometabolic disease. Methods: Data on 413,417 individuals were acquired from the National Health Interview Survey from 2005-2018. Variables included self-reported sleep duration, lifetime diagnosis of hypertension, coronary heart disease, diabetes, and pre-diabetes, and obesity. Population-weighted linear models estimated annual trends in sleep duration, while population-weighted quasi-Poisson models estimated the prevalence risk of cardiometabolic disease as a function of sleep duration. Results: Average daily sleep duration decreased -0.62 minutes annually from 2005-2018. A significant race/ethnicity interaction was found. Compared to Non-Hispanic Whites, the rate of decline was 119% greater among Blacks/African-Americans, 206% greater among Mexican-Americans, 4% greater in other Hispanics/Latinos, and 43% greater in Asians. A 1-hour loss in daily sleep duration was linked to 4% greater prevalence of hypertension, 3% greater prevalence of diabetes, and 8% greater prevalence of obesity after adjusting for age, sex, employment, marital status, and survey year. A significant race/ethnicity interaction was observed, with differential elevated risk of cardiometabolic risk factor prevalence associated with declining sleep (see table). Conclusion: There is a secular decline in U.S. daily sleep duration that is disproportionately impacting Black/African-American and Mexican individuals. Moreover, reduced sleep duration is associated with more prevalent cardiometabolic disease and these relationships are disproportionately impacting racial/ethnic minority groups.
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