Abstract

ObjectivesShort and long sleep duration are associated with metabolic syndrome. However, there is limited research on the association between sleep quality and metabolic syndrome, and thus the aim of this study is to investigate this relationship.Materials and MethodsThe cross-sectional baseline data were collected from the decoded database of the Prevention Health Center of National Cheng Kung University Hospital from 2002 to 2006. The diagnosis of metabolic syndrome was according to the statement of the American Heart Association/National Heart, Lung, and Blood Institute. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates poorer sleep quality, and a global PSQI score greater than five differentiates poor from good sleepers.ResultsOf the 3,435 subjects recruited, 899 (26.2%) had metabolic syndrome. Subjects with metabolic syndrome had higher PSQI and prevalence of poor sleepers than those without metabolic syndrome. The multivariate lineal regression analysis showed that female gender, metabolic syndrome, sleep duration, snoring, alcohol drinking, and habitual exercise were independent predictors of PSQI. When substituting metabolic syndrome with the five components, hyperglycemia and low high-density lipoprotein cholesterol (HDL-C) were positively associated with PSQI. The multivariate logistic regression analyses showed that female gender, metabolic syndrome, sleep duration, and snoring were independently associated with being poor sleepers. Of the five components, only low HDL-C was an independent predictor of being poor sleepers.ConclusionsSubjects with metabolic syndrome have higher global PSQI scores and a higher risk of being poor sleepers. Of the five components of metabolic syndrome, hyperglycemia and low HDL-C are independently associated with the global PSQI scores, while low HDL-C is an independent predictor of being poor sleepers.

Highlights

  • Adequate sleep quality and quantity are important for the normal functioning of daily metabolic and hormonal processes and appetite regulation [1]

  • The multivariate lineal regression analysis showed that female gender, metabolic syndrome, sleep duration, snoring, alcohol drinking, and habitual exercise were independent predictors of Pittsburgh Sleep Quality Index (PSQI)

  • The multivariate logistic regression analyses showed that female gender, metabolic syndrome, sleep duration, and snoring were independently associated with being poor sleepers

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Summary

Introduction

Adequate sleep quality and quantity are important for the normal functioning of daily metabolic and hormonal processes and appetite regulation [1]. Many studies have shown that sleep duration is associated with diabetes [3,4], obesity [5,6], cardiovascular disease [7,8], and all-cause mortality [9]. Metabolic syndrome represents a cluster of coronary heart disease risk factors, including obesity, elevated blood pressure, high fasting plasma glucose and triglyceride concentrations, and low serum high-density lipoprotein cholesterol levels [13]. It is associated with several potentially modifiable lifestyle factors, such as smoking, alcohol consumption, and physical inactivity [14]. In the Coronary Artery Risk Development in Young Adults Sleep Study, where actigraphy was used to assess sleep, both shorter sleep duration and greater sleep fragmentation were associated with higher body mass index [18], but not with markers of glucose metabolism in non-diabetic middle-aged adults [19]

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