SLEEP - Sleep Is Associated with the Metabolic Syndrome in a Multi-Ethnic Cohort of Midlife Women: The SWAN Sleep Study

VOLUME 35, ISSUE 06

SLEEP IS ASSOCIATED WITH METABOLIC SYNDROME IN MIDLIFE WOMEN
Sleep Is Associated with the Metabolic Syndrome in a Multi-Ethnic Cohort of Midlife Women: The SWAN Sleep Study

http://dx.doi.org/10.5665/sleep.1874

Martica H. Hall, PhD¹; Michele L. Okun, PhD¹; MaryFran Sowers, PhD²; Karen A. Matthews, PhD¹; Howard M. Kravitz, DO, MPH³; Kimberly Hardin, MD⁴; Daniel J. Buysse, MD¹; Joyce T. Bromberger, PhD¹; Jane F. Owens, DrPH¹; Irina Karpov, MS¹; Mark H. Sanders, MD¹

¹University of Pittsburgh, Pittsburgh, PA; ²University of Michigan, Ann Arbor, MI; ³Rush University Medical Center, Chicago, IL; ⁴University of California at Davis, Davis, CA

Table of Contents

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Study Objectives:

We evaluated associations among subjective and objective measures of sleep and the metabolic syndrome in a multi-ethnic sample of midlife women.

Design:

Cross-sectional study.

Setting:

Participants' homes.

Participants:

Caucasian (n = 158), African American (n = 125), and Chinese women (n = 57); mean age = 51 years. Age range = 46-57 years.

Interventions:

None.

Measurements and Results:

Metabolic syndrome was measured in the clinic and sleep quality was assessed by self-report. Indices of sleep duration, continuity/fragmentation, depth, and sleep disordered breathing were assessed by in-home polysomnography (PSG). Covariates included sociodemographics, menopausal status, use of medications that affect sleep, and self-reported health complaints and health behaviors known to influence metabolic syndrome risk. Logistic regression was used to test the hypothesis that the metabolic syndrome would be associated with increased subjective sleep complaints and PSG-assessed sleep disturbances. In univariate analyses, the metabolic syndrome was associated with decreased sleep duration and efficiency and increased NREM beta power and apnea-hypopnea index (AHI). After covariate adjustment, sleep efficiency (odds ratio [OR] = 2.06, 95% confidence interval [CI]: 1.08-3.93), NREM beta power (OR = 2.09, 95% CI: 1.09-3.98), and AHI (OR = 1.86, 95% CI: 1.40-2.48) remained significantly associated with the metabolic syndrome (odds ratio values are expressed in standard deviation units). These relationships did not differ by race.

Conclusions:

Objective indices of sleep continuity, depth, and sleep disordered breathing are significant correlates of the metabolic syndrome in midlife women, independent of race, menopausal status and other factors that might otherwise account for these relationships.

Citation:

Hall MH; Okun ML; Sowers M; Matthews KA; Kravitz HM; Hardin K; Buysse DJ; Bromberger JT; Owens JF; Karpov I; Sanders MH. Sleep is associated with the metabolic syndrome in a multi-ethnic cohort of midlife women: the SWAN Sleep Study. SLEEP 2012;35(6):783-790.