Table 4.
Longitudinal analysis of sleep duration and insomnia with the risk of metabolic syndrome and its components using generalized estimating equation models
| MetS | Waist > 88 cm | Hypertension | ||||
|---|---|---|---|---|---|---|
| Model 1 | Model 2 | Model 1 | Model 2 | Model 1 | Model 2 | |
| Average sleep hours | OR (95%CI) | OR (95%CI) | OR (95%CI) | OR (95%CI) a | OR (95%CI) | OR (95%CI) a |
| < 6 | 1.11 (0.83–1.53) | 0.98 (0.70–1.37) | 1.06 (0.75–1.49) | 1.04 (0.74–1.48) | 1.41 (1.03–1.92) | 1.35 (1.01–1.91) |
| 6- < 7 | 1.16 (0.90–1.49) | 1.11 (0.86–1.42) | 0.92 (0.70–1.20) | 0.85 (0.65–1.11) | 1.26 (0.99- 1.61) | 1.24 (0.97–1.58) |
| 7- < 8 | ref | ref | ref | ref | ref | ref |
| 8- < 9 | 1.14 (0.82–1.59) | 1.13 (0.82–1.59) | 0.62 (0.41–0.93) | 0.62 (0.41–0.94) | 1.05 (0.75–1.45) | 1.02 (0.73–1.42) |
| ≥ 9 | 0.62 (0.22–1.78) | 0.68 (0.23–1.90) | 0.40 (0.11–1.42) | 0.43 (0.12–1.54) | 1.00 (0.41–2.45) | 1.09 (0.45–2.66) |
| > 2 h increase | 1.27 (0.74–2.18) | 1.15 (0.67–2.00) | 0.83 (0.40–1.70) | 0.82 (0.40–1.69) | 1.22 (0.68–2.19) | 1.20 (0.66–2.17) |
| > 2 h decrease | 1.62 (1.00–2.62) | 1.47 (0.90–2.37) | 0.55 (0.25–1.20) | 0.55 (0.25–1.21) | 1.41 (0.83–2.38) | 1.39 (0.82–2.37) |
| Quality of sleep over time | ||||||
| Stable restful | ref | ref | ref | ref | ref | ref |
| Restful to insomnia | 1.44 (1.04–1.99) | 1.40 (1.01–1.94) | 1.04 (0.70–1.53) | 1.07 (0.72–1.59) | 1.26 (0.91–1.74) | 1.27 (0.91–1.77) |
| Insomnia to restful | 1.16 (0.84–1.61) | 1.14 (0.82–1.58) | 1.34 (0.95–1.89) | 1.28 (0.90–1.82) | 0.81 (0.57–1.14) | 0.80 (0.57–1.14) |
| Persistent insomnia | 1.39 (1.07–1.82) | 1.31 (0.99–1.73) | 1.18 (0.86–1.61) | 1.05 (0.75–1.47) | 1.12 (0.87–1.46) | 1.10 (0.84–1.46) |
| Fasting glucose ≥ 100 mg/dL | Triglycerides ≥ 150 mg/dL | HDL < 50 mg/dL | ||||
| Average sleep hours | OR (95%CI) | OR (95%CI) a | OR (95%CI) | OR (95%CI) a | OR (95%CI) | OR (95%CI) a |
| < 6 | 1.47 (0.87–2.49) | 1.19 (0.90–1.59) | 0.85 (0.62–1.17) | 0.79 (0.57–1.09) | 1.17 (0.81–1.68) | 1.06 (0.73–153) |
| 6- < 7 | 1.10 (0.77–1.57) | 1.06 (0.85–1.32) | 0.92 (0.73–1.16) | 0.89 (0.70–1.13) | 1.28 (0.97–169) | 1.26 (0.96–1.66) |
| 7- < 8 | ref | ref | ref | ref | ref | ref |
| 8- < 9 | 0.97 (0.64–1.44) | 1.09 (0.81–1.47) | 0.88 (0.63–1.22) | 0.88 (0.63–1.22) | 1.23 (0.85–1.77) | 1.26 (0.87–1.82) |
| ≥ 9 | 1.09 (0.42–2.85) | 1.46 (0.71–3.03) | 0.56 (0.21–1.51) | 0.56 (0.21–1.51) | 1.19 (0.46–3.04) | 1.26 (0.49–3.24) |
| > 2 h increase | 1.13 (0.62–2.06) | 0.94 (0.57–1.56) | 1.37 (0.84–2.23) | 1.32 (0.81–2.15) | 0.90 (0.44–1.85) | 0.92 (0.45–1.90) |
| > 2 h decrease | 0.92 (0.54–1.55) | 0.96 (0.60–1.54) | 0.98 (0.59–1.62) | 0.98 (0.59–1.62) | 1.37 (0.77–2.43) | 1.26 (0.70–2.29) |
| Quality of sleep over time | ||||||
| Stable restful | ref | ref | ref | ref | ref | ref |
| Restful to insomnia | 1.22 (0.92–1.61) | 1.24 (0.93–1.65) | 1.51 (1.10–2.06) | 1.48 (1.08–2.03) | 1.07 (0.73–1.57) | 1.00 (0.68–1.47) |
| Insomnia to restful | 1.21 (0.92–1.58) | 1.20 (0.91–1.58) | 0.92 (0.67–1.26) | 0.92 (0.67–1.27) | 0.99 (0.68–1.43) | 1.06 (0.72–1.54) |
| Persistent insomnia | 1.21 (0.95–1.53) | 1.21 (0.94–1.56) | 0.96 (0.73–1.26) | 0.96 (0.73–1.26) | 1.28 (0.95–1.72) | 1.25 (0.91–1.71) |
Abbreviations: OR Odds ratio, CI Confidence interval, MetS metabolic syndrome, HDL high density lipoproteins
Model1 adjusted for age, ethnicity, and study participation
Model 2 adjusted as model 1 plus clinical trial arm, educational level, hormone therapy use, smoking status, pack-years of smoking, alcohol intake, physical activity, coffee intake, depression, age at menopause, and marital status (see Table 2 for details)