Abstract
BackgroundThe U-shaped associations between sleep durations and cardiometabolic risk factors (glycated hemoglobin levels, obesity, hypertriglyceridemia, hypertension and cholesterol levels) are still inconclusive. Moreover, as sleep is comprised of quantitative and qualitative aspects, exploring both insomnia symptoms and sleep duration are relevant when evaluating the potential effects of sleep problems on health. The aim was to evaluate sex-specific associations between sleep problems and cardiometabolic risk factors.MethodsThis cross-sectional study used data from wave two of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), including 7491 women and 6232 men. Questionnaires were administered to provide information about socioeconomic conditions, lifestyle, and sleep characteristics. A 12-h fasting blood sample was drawn to measure serum cholesterol, triglycerides, and glycated hemoglobin. Blood pressure, weight and height were also measured using standard equipment. Generalized additive models were used to evaluate the curve shape of the relationship between self-reported sleep duration and the outcomes. Logistic regression was performed to investigate the magnitude of the associations of self-reported sleep duration, insomnia symptoms, and short sleep plus insomnia symptoms with cardiometabolic risk factors.ResultsFor women, self-reported sleep duration and insomnia symptoms (either separately or linked to short sleep duration) were associated with obesity, hypertension and glycated hemoglobin after adjusting for the confounders. The magnitudes of the associations between self-reported short sleep duration plus insomnia symptoms and the outcomes were slightly increased, considering sleep duration or insomnia symptoms separately. For men, both long sleep duration and insomnia symptoms were associated with hypertriglyceridemia after adjusted for the confounders.ConclusionThese findings suggest possible sex-specific patterns, since obesity, hypertension and high glycated hemoglobin were associated with self-reported sleep duration and insomnia symptoms in women, but not in men, and reinforce the importance of considering quantitative and qualitative aspects of sleep for the prevention and management of the outcomes.
Highlights
The U-shaped associations between sleep durations and cardiometabolic risk factors are still inconclusive
Silva-Costa et al Archives of Public Health (2020) 78:48 (Continued from previous page). These findings suggest possible sex-specific patterns, since obesity, hypertension and high glycated hemoglobin were associated with self-reported sleep duration and insomnia symptoms in women, but not in men, and reinforce the importance of considering quantitative and qualitative aspects of sleep for the prevention and management of the outcomes
A U-shaped relationship was suggested between self-reported sleep duration and obesity, hypertension and glycated hemoglobin after adjusting for the confounders; adequate self-reported sleep duration (> 6 h - ≤ 8 h) was not associated with cardiometabolic risk factors
Summary
The U-shaped associations between sleep durations and cardiometabolic risk factors (glycated hemoglobin levels, obesity, hypertriglyceridemia, hypertension and cholesterol levels) are still inconclusive. Meta-analysis studies showed that the risk of type 2 diabetes [7] and hypertension [3] were, respectively, 84 and 20% higher for subjects who reported difficulties in maintaining their sleep [3, 7]. In a meta-analysis including studies on insomnia and obesity published in the past 10 years, the authors stated that associations are weak, for European samples [19]. These findings stress that there is no single pattern of results and reinforce the need for studies with other population groups
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