Joint Association of Sleep Onset Time and Sleep Duration With Cardiometabolic Health Outcome

Background: The association of sleep onset time and duration with cardiometabolic health is not well characterized.

Methods And Results: This study included 6696 adults aged 20 to 80 years from the NHANES (National Health and Nutrition Examination Study) 2015 to 2018. Participants were categorized into 9 groups according to the cross-tabulation of sleep onset time (<22:00 [early], 22:00-23:59 [optimal], and ≥24:00 [late]) and duration (<7 hours [insufficient], 7-8 hours [sufficient], and ≥9 hours [excessive]), with optimal sleep onset time and sufficient duration as the reference. The primary outcomes included hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, central obesity, and metabolic syndrome. Inappropriate sleep onset time and sleep duration were associated with increased odds of hypertension, hypertriglyceridemia, and metabolic syndrome, especially among participants aged 40 to 59 years. Compared with men reporting optimal onset and sufficient duration, men reporting optimal onset with excessive duration (odds ratio [OR]: 2.01 [95% CI, 1.12-3.58]) and late onset with insufficient duration (OR, 1.74 [95% CI, 1.13-2.68]) had higher odds of metabolic syndrome. Compared with women reporting optimal onset and sufficient duration, women reporting optimal onset and insufficient duration (OR, 1.61 [95% CI, 1.11-2.32]) and early onset and excessive duration (OR, 2.16 [95% CI, 1.30-3.57]) had higher odds of hypertension, and women reporting late onset and excessive duration (OR, 5.64 [95% CI, 1.28-6.77]) were at the highest odds of hypertriglyceridemia.

Conclusions: Late sleep onset as well as insufficient or excessive sleep duration are associated with adverse cardiometabolic outcomes, particularly in participants aged 40 to 59 years.