Association of sleep characteristics with cardiovascular and metabolic risk factors in a population sample: the Chicago Area Sleep Study

Objectives To investigate the association of sleep characteristics with prevalent hypertension, diabetes, and obesity in a multiethnic cohort. Design This study used a population-based cross-sectional study design. Setting Participants were recruited between 2009 and 2011 from Chicago, Illinois, and the surrounding suburbs. Participants Participants were 492 adults aged 35 to 64 years who self-reported as white, black, Hispanic, or Asian and who had a low likelihood of sleep apnea based on the apnea screening questionnaires and 1 night of apnea screening using an in-home device (apnea hypopnea index <15 or oxygen desaturation index  <10). Measurements Participants wore a wrist actigraphy monitor (Actiwatch™) for 7 days. During a clinical examination, participants completed questionnaires about sleep, other health behaviors, and medical history and had their blood pressure, anthropometric measures, and fasting blood glucose measured; metabolic risk factors were determined based on standard clinical guidelines. Results The prevalence of hypertension, obesity, and diabetes was 17.1%, 5.5%, and 35.4%, respectively. Sleep duration was not associated with any cardiovascular risk factor. There was a significantly increased odds for hypertension (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.08) and obesity (OR, 1.03; 95% CI, 1.00-1.05) associated with higher sleep fragmentation (per 1%). There was also a significantly increased odds for hypertension associated with poorer self-reported sleep quality (OR, 1.14 [95% CI, 1.05-1.24] per 1-unit higher Pittsburgh Sleep Quality Index global score). Conclusion Objective and self-reported sleep quality may be more important than duration in relation to prevalent hypertension.