Association between sleep duration and ideal cardiovascular health among US adults, national health and nutrition examination survey, 2013-2016

Abstract

Introduction Short or long sleep duration is a risk factor for cardiovascular disease, but the association between sleep duration and cardiovascular health is unclear. Our objective was to quantify the association between sleep duration and ideal cardiovascular health (CVH) in US adults. We hypothesized that very short (<6 h) and very long (≥9 h) sleep duration were associated with poorer CVH compared with sleep lasting 7 to <8 hours. Methods We conducted a cross-sectional evaluation of the nationally representative National Health and Nutrition Examination Survey in 2 cycles (2013-2014 and 2015-2016). Participants were 7,784 cardiovascular disease-free US adults aged 20 to 75. Self-reported sleep duration was categorized as <6 hours, 6 to <7 hours, 7 to <8 hours, 8 to <9 hours, and ≥9 hours. The American Heart Association's ideal CVH metrics were used to determine the number of ideal CVH components, dichotomized as ideal (5-7 components) or not ideal (0-4 components). Survey-weighted logistic and linear regression models were used to determine the association between sleep duration and ideal CVH. Results The weighted prevalences of those who slept 7 to <8 hours were 30.4%, very short sleep duration (<6 h), 9.0%, and very long duration (≥9 h), 13.5%. Only 21.3% of the population had ideal CVH. Compared with 7 to <8 hours, very short duration (OR = 0.65; 95% confidence interval [CI], 0.47-0.90) and very long duration (OR = 0.72; 95% CI, 0.55-0.94) were associated with decreased odds of ideal CVH. We confirmed findings by using linear regression. Conclusions Very short and very long sleep duration were associated with decreased odds of ideal CVH and lower mean CVH scores. Future research should focus on clarifying causal associations between sleep duration and ideal CVH.