Associations of sleep duration and quality with cardiometabolic risk factors in US adults: Evidence from the 2022 National Health Interview Survey.

Authors

Kushagra Vashist, Laura Ward, Amit Shah, Viola Vaccarino, Dayna A Johnson

Published in

Sleep health. Aug 26, 2026. Epub Aug 26, 2026.

Abstract

We examined the association between sleep duration and quality with cardiometabolic risk factors, assessed whether these associations varied by socioeconomic status, and identified prevalent risk factor combinations in those with poor sleep health.
We conducted a cross-sectional analysis of 25,433 adults using the 2022 National Health Interview Survey data. Sleep health exposures included self-reported sleep duration (<7, 7-9, >9 h), sleep quality measures (frequency of feeling well rested, difficulty falling asleep, difficulty staying asleep), and a composite sleep health indicator. Cardiometabolic risk factors included overweight/obesity, diabetes, hypertension, and hyperlipidemia. We examined the mean count of cardiometabolic risk factors (individual range: 0-4) and patterns of cardiometabolic risk factor combinations across sleep measures using Poisson regression with marginal standardization for covariates, accounting for the complex survey design.
Population-average cardiometabolic risk factor count was 9% higher among short sleepers, 15% to 20% higher across poor sleep quality measures, and 18% higher among those without healthy composite sleep compared with healthy reference groups. Associations between difficulty staying asleep and mean cardiometabolic risk factor count were stronger among those with lower SES (p-interaction ≤0.001) on the ratio scale. Poor sleep quality was associated with more severe CMRF combinations and patterns, while sleep duration showed heterogeneous associations across cardiometabolic outcomes.
Poor sleep quality and short sleep duration were associated with higher population-level cardiometabolic risk factor burden. Associations for difficulty staying asleep were stronger among individuals with lower socioeconomic status. Poor sleep quality was also associated with more severe cardiometabolic risk factor combinations, suggesting sleep quality may be a potential target for multimorbidity prevention.

PMID:
42648984
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

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