Abstract P357: The Association between Sleep and Waist Circumference Varies among Women as a Function of Race and Ethnicity

Abstract

Background: Waist circumference (WC) is an established predictor of global 10-y risk for cardiovascular disease (CVD). Sleep duration and quality have also been associated with CVD risk. The association between sleep and WC and how it may vary among racially/ethnically diverse women has not been fully established. Hypothesis: We assessed the hypothesis that sufficient sleep duration (≥6 h), good sleep quality, and lower insomnia severity would be associated with reduced WC and that associations would vary by race/ethnicity. Methods: Participants were English or Spanish speaking females (n=50), aged 20-79y, recruited as visitors of patients or members of the community surrounding an urban medical center, as part of the American Heart Association Go Red for Women Strategically Focused Research Network. Sleep duration and quality were assessed using the Pittsburgh Sleep Quality Index, and insomnia was assessed using the Insomnia Severity Index (ISI). Anthropometric measures were obtained by trained personnel. A standardized health questionnaire was used to obtain medical and demographic data. Linear regression models were used to evaluate cross-sectional associations between sleep patterns and WC in the overall sample and stratified by race/ethnicity. Results: The mean age of the sample was 41±18y and 56% (28 of 50) were racial/ethnic minorities. The mean body mass index (BMI) was 26.0±4.5 kg/m 2 and half of women had a BMI ≥25 kg/m 2 . One third were current/former smokers, 36% (18 of 50) were postmenopausal and 60% (30 of 50) reported a history of chronic disease. In the overall sample, a sleep duration of <6 versus ≥6 h was associated with higher WC in univariate (beta(SE)=4.90(1.44), p=.001) and multivariable models adjusted for age, race/ethnicity, education, marital status, menopausal status and history of chronic disease (beta(SE): 4.38(1.76), p=.02). In analyses stratified by race/ethnicity, null associations between sleep duration and WC were observed for non-Hispanic whites in univariate (beta(SE)=3.30(2.19), p=.15) and multivariable-adjusted models (beta(SE)=0.97(2.68), p=.72). However, among racial/ethnic minorities, a sleep duration <6 versus ≥6 h was associated with higher WC in both univariate (beta(SE)=5.65(1.07), p=.01) and multivariable-adjusted models (beta(SE)=6.68(2.12), p=.01). In general, the mean WC among minority women who slept <6 versus ≥6 h was 41.1 versus 35.5 inches (p=.03). Sleep quality and ISI were not significantly associated with WC. Conclusions: In this diverse sample of women, sleeping for ≥6 h/night had a protective impact on WC, particularly among minority women. These preliminary findings suggest that minority women with insufficient sleep may be particularly prone to central adiposity, thereby predisposing them to increased CVD risk. Analyses are ongoing to confirm these results in a larger sample.