CoChat
Sign Up
Cited by 300Sleep and related disordersSleep and Work-Related FatigueCircadian rhythm and melatonin

Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors

Open access
Grandner, Michael A., Chakravorty, Subhajit, Perlis, Michael L., Oliver, Linden, Gurubhagavatula, Indira·2014·Sleep Medicine
DOI 10.1016/j.sleep.2013.09.012PMC PMC3947242
Open this paper in CoChat — free account

Abstract

Background Self-reported short and/or long sleep duration have been associated with adverse cardiometabolic health outcomes in laboratory and epidemiologic studies, but interpretation of such data has been limited by methodological issues. Methods Adult respondents of the 2007-2008 US National Health and Nutrition Examination Survey (NHANES) were examined in a cross-sectional analysis (N=5,649). Self-reported sleep duration was categorized as very short (<5hrs), short (5-6hrs), normal (7-8hrs) or long (≥9hrs). Obesity, diabetes, hypertension, and hyperlipidemia were assessed by self-reported history and objectively. Statistical analyses included univariate comparisons across sleep duration categories for all variables. Binary logistic regression analyses, cardiometabolic factor as outcome and with sleep duration category as predictor, were assessed with and without covariates. Observed relationships were further assessed for dependence on race/ethnicity. Results In adjusted analyses, very short sleep was associated with self-reported hypertension (OR=2.02, 95%CI[1.45, 2.81], p<0.0001), self-reported hyperlipidemia (OR=1.96, 95%CI[1.43, 2.69], p<0.0001), objective hyperlipidemia (OR=1.41, 95%CI[1.04, 1.91], p=0.03), self-reported diabetes (OR=1.76, 95%CI[1.13, 2.74], p=0.01), and objective obesity (OR=1.53, 95%CI[1.13, 2.06], p=0.005). Regarding short sleep (5-6hrs), in adjusted analyses, elevated risk was seen for self-reported hypertension (OR=1.22, 95%CI[1.02, 1.45], p=0.03) self-reported obesity (OR=1.21, 95%CI[1.03, 1.43], p=0.02) and objective obesity (OR=1.17, 95%CI[1.00, 1.38], p<0.05). Regarding long sleep (≥9hrs), no elevated risk was found for any outcomes. Interactions with Race/Ethnicity were significant for all outcomes; race/ethnicity differences in patterns of risk varied by outcome studied. In particular, the relationship between very short sleep and obesity was strongest among Blacks/African-Americans and the relationship between short sleep and hypertension is strongest among non-Hispanic Whites, Blacks/African-Americans, and non-Mexican Hispanics/Latinos. Conclusions Short sleep duration is associated with self-reported and objectively-determined adverse cardiometabolic outcomes, even after adjustment for many covariates. Also, these patterns of risk depend on race/ethnicity.

AI snapshot

Written from the paper’s full text.

TL;DR

In 2007–2008 NHANES adults, very short sleep (<5 h) was associated with several self-reported and objectively determined cardiometabolic risk factors after adjustment, while long sleep (≥9 h) showed no elevated risk. These patterns varied by race/ethnicity.

Key findings

  • Very short sleep (<5 h) was associated in adjusted analyses with self-reported hypertension (OR=2.02, 95%CI[1.45, 2.81]), self-reported hyperlipidemia (OR=1.96, 95%CI[1.43, 2.69]), objective hyperlipidemia (OR=1.41, 95%CI[1.04, 1.91]), self-reported diabetes (OR=1.76, 95%CI[1.13, 2.74]), and objective obesity (OR=1.53, 95%CI[1.13, 2.06]).
  • Short sleep (5–6 h) was associated in adjusted analyses with self-reported hypertension (OR=1.22, 95%CI[1.02, 1.45]), self-reported obesity (OR=1.21, 95%CI[1.03, 1.43]), and objective obesity (OR=1.17, 95%CI[1.00, 1.38]).
  • Long sleep (≥9 h) showed no elevated risk for any outcomes after adjustment; elevated risk was found only for objective diabetes in unadjusted analyses.
  • Race/ethnicity interactions were significant for self-reported and objective hypertension, hyperlipidemia, diabetes, and obesity (p-values from <0.0001 to 0.007); for example, the very-short-sleep–obesity relationship was strongest among Blacks/African-Americans, and the short-sleep–hypertension relationship was strongest among non-Hispanic Whites, Blacks/African-Americans, and non-Mexican Hispanics/Latinos.

Methods

  • Cross-sectional analysis of 2007–2008 US National Health and Nutrition Examination Survey (NHANES) adult respondents ages 18–80+ years with complete data (N=5,649), using census-weighted, nationally representative data.
  • Self-reported sleep duration was categorized as very short (<5 h), short (5–6 h), normal (7–8 h; reference), or long (≥9 h).
  • Outcomes were self-reported and objective hypertension, hyperlipidemia, diabetes, and obesity; analyses used chi-square tests and binary logistic regression with and without covariates, plus race/ethnicity interaction and stratified analyses in STATA/SE 12.

Limitations

  • The paper states that the cross-sectional design cannot infer causality; self-reported integer sleep duration may cause misclassification and attenuate associations; prospective diary and actigraphy would be better; extreme sleepers represent a small population subset; BMI does not capture central adiposity or some relevant factors, and residual confounding may exist.
  • The paper notes that race/ethnicity stratified analyses reduce statistical power, especially in less populous groups.
  • The text makes evident that self-reported versus objective outcome discrepancies may reflect recall bias, social desirability, state-dependent factors, or measurement error in the sleep duration item.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.sleep.2013.09.012

Cites

126 of 126 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 39 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Among Asian/other respondents, very short sleep was associated with elevated risk of self-reported and objective hyperlipidemia.

    “Among Asian/other respondents, elevated risk for self-reported and objective hyperlipidemia were found for very short sleep.”
    Quote in the paperSubstantial claim
  • Findingown data

    For non-Hispanic white respondents, long sleep was associated with elevated risk of objective hyperlipidemia.

    “objective hyperlipidemia among long sleepers”
    Quote in the paperSubstantial claim
  • Findingown data

    In unadjusted analyses, long sleep (≥9 hours) was associated with elevated risk only for objective diabetes.

    “Regarding long sleep (≥9hrs), elevated risk was found only for objective diabetes, in unadjusted analyses only.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In adjusted analyses, short sleep (5-6 hours) was associated with self-reported hypertension (OR=1.22, 95% CI 1.02-1.45, p=0.03).

    “elevated risk was seen for self-reported hypertension (OR=1.22, 95%CI[1.02, 1.45], p=0.03)”
    Quote in the paperSubstantial claim
  • Findingown data

    The relationship between short sleep and hypertension was strongest among non-Hispanic Whites, Blacks/African-Americans, and non-Mexican Hispanics/Latinos.

    “the relationship between short sleep and hypertension is strongest among non-Hispanic Whites, Blacks/African-Americans, and non-Mexican Hispanics/Latinos.”
    Quote in the paperSubstantial claim
  • May combine two claims. 17
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 11

  • May combine two claims.

    Findingown data

    For non-Hispanic white respondents, very short sleep was associated with elevated risk of self-reported hypertension, self-reported hyperlipidemia, objective hyperlipidemia, and self-reported diabetes.

    “for non-Hispanic white respondents, elevated risk was found for self-reported hypertension, self-reported hyperlipidemia, objective hyperlipidemia, and self-reported diabetes among very short sleepers”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    In adjusted analyses, all relationships for short sleep except objective hypertension persisted.

    “In adjusted analyses, all relationships except objective hypertension persisted.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For Mexican-Americans, short sleep was associated with elevated risk of self-reported hypertension and self-reported obesity, and long sleep was associated with decreased self-reported hyperlipidemia.

    “For Mexican-Americans, elevated risk of self-reported hypertension and self-reported obesity were found for short sleep and decreased self-reported hyperlipidemia was seen in long sleep.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For black/African-American respondents, very short sleep was associated with elevated risk of self-reported hypertension, self-reported obesity, and objective obesity.

    “For black/African-American respondents, elevated risk of self-reported hypertension, self-reported obesity, and objective obesity were found for very short sleep.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For other Hispanic/Latino respondents, very short sleep was associated with elevated risk of self-reported hypertension, and short sleep was associated with elevated risk of objective diabetes.

    “For other Hispanic/Latino respondents, elevated risk of self-reported hypertension was found for very short sleep and objective diabetes for short sleep.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The present study found that only very short sleep was associated with elevated diabetes risk when measured using the standard survey question; when an objective determination was used, elevations were not found.

    “The present study found that only very short sleep associated with elevated diabetes risk when measured using the standard survey question. When an objective determination was used, elevations were not found.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The results of the present study extend previous findings; for all outcomes except objective diabetes, the relationship between sleep duration and cardiometabolic disease differed by race/ethnicity.

    “The results of the present study extend the later findings; for all outcomes except objective diabetes, the relationship between sleep duration and cardiometabolic disease differed by race/ethnicity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In unadjusted analyses, short sleep (5-6 hours) was associated with elevated risk for self-reported and objective hypertension and self-reported and objective obesity.

    “In unadjusted analyses, short sleep (5-6hrs) was associated with elevated risk was seen for self-reported and objective hypertension and self-reported and objective obesity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After adjustment for covariates, for very short sleep, significant relationships remained for self-reported hypertension, self-reported and objective hyperlipidemia, self-reported diabetes, and objective obesity; all other variables were attenuated to trends (p<0.10).

    “After adjustment for covariates, significant relationships remained for self-reported hypertension, self-reported and objective hyperlipidemia, self-reported diabetes, and objective obesity. All other variables were attenuated to trends (p<0.10).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The relationship between very short sleep and self-reported hypertension was seen for all groups except Mexican-Americans and Asians/Others, with the strongest effect seen among Other Hispanics/Latinos.

    “the relationship between very short sleep and self-reported hypertension was seen for all groups except Mexican-Americans and Asians/Others, with the strongest effect seen among Other Hispanics/Latinos.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Very short sleep (<5 hours) was most strongly associated with the widest range of adverse outcomes, followed by short sleep (5-6 hours).

    “Very short sleep (<5hrs) was most strongly associated with the widest range of adverse outcomes, followed by short sleep (5-6hrs).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The study included statistical controls for differential effects of race/ethnicity.

    “statistical controls for differential effects of race/ethnicity”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The distribution of sleep duration values in the present study is consistent with that reported by other cohorts.

    “Our distribution of sleep duration values is consistent with that reported by other cohorts.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [128] Patel SR Malhotra A Gao X Hu FB Neuman MI Fawzi WW A prospective study of sleep duration and pneumonia risk in women. Sleep 2012 35 97 101 22215923 PMC3242694 source

      Not checked in the free run.

    • cites [44] Patel SR Blackwell T Ancoli-Israel S Stone KL Osteoporotic Fractures in Men-Mr OSRG. Sleep characteristics of self-reported long sleepers. Sleep 2012 35 641 8 22547890 PMC3321423 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Small-scale experimental studies have shown that short-term sleep deprivation may lead to metabolic dysregulation, elevated inflammation, and elevated blood pressure.

    “Small-scale experimental studies have shown that short-term sleep deprivation may lead to metabolic dysregulation[29-34], elevated inflammation[35, 36], and elevated blood pressure[37].”
    Quote in the paperSubstantial claim0 of 9 sources checked
    • cites [29] Schmid SM Hallschmid M Jauch-Chara K Wilms B Lehnert H Born J Disturbed glucoregulatory response to food intake after moderate sleep restriction. Sleep 2011 34 371 7 21358855 PMC3041714 source

      Not checked in the free run.

    • cites [30] Darukhanavala A Booth JN 3rd Bromley L Whitmore H Imperial J Penev PD Changes in insulin secretion and action in adults with familial risk for type 2 diabetes who curtail their sleep. Diabetes Care 2011 34 2259 64 21836106 PMC3177719 source

      Not checked in the free run.

    • cites [31] Donga E van Dijk M van Dijk JG Biermasz NR Lammers GJ van Kralingen KW A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects. J Clin Endocrinol Metab 2010 95 2963 8 20371664 source

      Not checked in the free run.

    • cites [32] Donga E van Dijk M van Dijk JG Biermasz NR Lammers GJ van Kralingen K Partial sleep restriction decreases insulin sensitivity in type 1 diabetes. Diabetes Care 2010 33 1573 7 20357381 PMC2890361 source

      Not checked in the free run.

    • cites [33] Buxton OM Pavlova M Reid EW Wang W Simonson DC Adler GK Sleep restriction for 1 week reduces insulin sensitivity in healthy men. Diabetes 2010 59 2126 33 20585000 PMC2927933 source

      Not checked in the free run.

    • cites [34] Spiegel K Leproult R Van Cauter E Impact of sleep debt on metabolic and endocrine function. Lancet 1999 354 1435 9 10543671 source

      Not checked in the free run.

    • cites [35] Faraut B Boudjeltia KZ Vanhamme L Kerkhofs M Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep Med Rev 2012 16 137 49 21835655 source

      Not checked in the free run.

    • cites [36] Mullington JM Haack M Toth M Serrador JM Meier-Ewert HK Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. Prog Cardiovasc Dis 2009 51 294 302 19110131 PMC3403737 source

      Not checked in the free run.

    • cites [37] Robillard R Lanfranchi PA Prince F Filipini D Carrier J Sleep deprivation increases blood pressure in healthy normotensive elderly and attenuates the blood pressure response to orthostatic challenge. Sleep 2011 34 335 9 21358850 PMC3041709 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Self-reported short and long sleep duration have been associated with hypertension.

    “hypertension[2, 13, 14]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [2] Altman NG Izci-Balserak B Schopfer E Jackson N Rattanaumpawan P Gehrman PR Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes. Sleep Med 2012 13 1261 70 23141932 PMC3527631 source

      Not checked in the free run.

    • cites [13] Mezick EJ Hall M Matthews KA Sleep duration and ambulatory blood pressure in black and white adolescents. Hypertension 2012 59 747 52 22275538 PMC3314491 source

      Not checked in the free run.

    • cites [14] Kim SJ Lee SK Kim SH Yun CH Kim JH Thomas RJ Genetic association of short sleep duration with hypertension incidence. Circ J 2012 76 907 13 22322875 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Although these relationships are likely to exist within the population, they are most relevant for only a small subset of the general population.

    “This suggests that although these relationships are likely to exist within the population, they are most relevant for only a small subset of the general population.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Epidemiologic studies carry methodological limitations such as inconsistent definitions of short and long sleep duration categories, inconsistent assessments, variable measurement techniques, and occasionally non-representative samples.

    “Epidemiologic studies, while typically more generalizable, carry methodological limitations such as inconsistent definitions of ‘short’ and ‘long’ sleep duration categories, inconsistent assessments (e.g., differently-worded survey items)[17], variable measurement techniques (e.g., diaries, actigraphy, polysomnography)[38], and occasionally non-representative samples”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [17] Grandner MA Patel NP Gehrman PR Perlis ML Pack AI Problems associated with short sleep: Bridging the gap between laboratory and epidemiological studies. Sleep Med Rev 2010 14 239 47 19896872 PMC2888649 source

      Not checked in the free run.

    • cites [38] Lauderdale DS Knutson KL Yan LL Liu K Rathouz PJ Self-reported and measured sleep duration: how similar are they? Epidemiology 2008 19 838 45 18854708 PMC2785092 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The data used in the analyses were weighted to control for representativeness, by following the procedures outlined in the current NHANES Analytic and Reporting Guidelines.

    “the data used in the following analyses were also weighted to control for representativeness, by following the procedures outlined in the current NHANES Analytic and Reporting Guidelines[52].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [52] Centers for Disease Control and Prevention Analytic and Reporting Guidelines: The National Health and Nutrition Examination Survey (NHANES) 2006 National Center for Health Statistics Hyattsville, MD

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Data on alternatives to BMI, menopausal status, menstrual cycle phase, and hormone replacement therapy use were not collected for NHANES.

    “These data were not collected for NHANES, and nor were data regarding menopausal status, menstrual cycle phase or use of hormone replacement therapy.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The number of covariates entered into the analyses was limited to mitigate reporting bias and to avoid the creation of models that were over-controlled.

    “the number of covariates entered into the analyses was limited to mitigate reporting bias and to avoid the creation of models that were over-controlled.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    The present study is limited to a cross-sectional analysis on prevalent subclinical disease and cannot make inferences of causality.

    “The present study is limited to a cross-sectional analysis on prevalent subclinical disease and cannot make inferences of causality.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The study used previously established categories of self-reported sleep duration.

    “previously established categories of self-reported sleep duration[2, 17, 47, 48]”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [2] Altman NG Izci-Balserak B Schopfer E Jackson N Rattanaumpawan P Gehrman PR Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes. Sleep Med 2012 13 1261 70 23141932 PMC3527631 source

      Not checked in the free run.

    • cites [17] Grandner MA Patel NP Gehrman PR Perlis ML Pack AI Problems associated with short sleep: Bridging the gap between laboratory and epidemiological studies. Sleep Med Rev 2010 14 239 47 19896872 PMC2888649 source

      Not checked in the free run.

    • cites [47] Grandner MA Jackson N Gerstner JR Knutson KL Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample. Appetite 2013 64 71 80 23339991 PMC3703747 source

      Not checked in the free run.

    • cites [48] Grandner MA Buxton OM Jackson N Sands-Lincoln M Pandey A Jean-Louis G Extreme sleep durations and increased C-reactive protein: effects of sex and ethnoracial group. Sleep 2013 36 769 79 23633760 PMC3624831 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Some misclassification bias may have occurred, which would have mitigated the strength of the associations that were found in the present analysis.

    “Since NHANES limits self-reports of sleep duration to integer values, which likely reflect usual habits in recent times, some misclassification bias may have occurred, which would have mitigated the strength of the associations that were found in the present analysis.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: NHANES self-reports of sleep duration, limited to integer values, likely reflect usual habits in recent times.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Race/ethnicity can be recognized as a risk factor for cardiometabolic disease.

    “It is also important to note that race/ethnicity can be recognized as a risk factor for cardiometabolic disease[87].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [87] Truman BI Smith CK Roy K Chen Z Moonesinghe R Zhu J Rationale for regular reporting on health disparities and inequalities - United States. MMWR Morb Mortal Wkly Rep 2011 60 3 10 21430613

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    NHANES limits self-reports of sleep duration to integer values.

    “Since NHANES limits self-reports of sleep duration to integer values, which likely reflect usual habits in recent times, some misclassification bias may have occurred, which would have mitigated the strength of the associations that were found in the present analysis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The NHANES is designed to ensure generalizability to the entire population across all ages.

    “The NHANES is designed to ensure generalizability to the entire population across all ages.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [51] Centers for Disease Control and Prevention National Health and Nutrition Examination Survey Phone Follow-Up Dietary Interviewer Procedures Manual 2008 U.S. Department of Health and Human Services Hyattsville, MD

      Not checked in the free run.

    • cites [52] Centers for Disease Control and Prevention Analytic and Reporting Guidelines: The National Health and Nutrition Examination Survey (NHANES) 2006 National Center for Health Statistics Hyattsville, MD

      Not checked in the free run.

    • cites [53] Centers for Disease Control and Prevention U.S. Department of Health and Human Services National Health and Nutrition Examination Survey Data 2008 National Center for Health Statistics Hyattsville, MD

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Self-reported short and long sleep duration have been associated with diabetes.

    “diabetes[4, 11, 12]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [4] Morselli LL Guyon A Spiegel K Sleep and metabolic function. Pflugers Arch 2012 463 139 60 22101912 PMC3289068 source

      Not checked in the free run.

    • cites [11] Zizi F Pandey A Murrray-Bachmann R Vincent M McFarlane S Ogedegbe G Race/ethnicity, sleep duration, and diabetes mellitus: analysis of the National Health Interview Survey. Am J Med 2012 125 162 7 22269619 PMC3266551 source

      Not checked in the free run.

    • cites [12] Kachi Y Ohwaki K Yano E Association of sleep duration with untreated diabetes in Japanese men. Sleep Med 2012 13 307 9 22305609 source

      Not checked in the free run.

27 of 27

  • The paper relies on this without support.

    NHANES self-reports of sleep duration, limited to integer values, likely reflect usual habits in recent times.

    “Since NHANES limits self-reports of sleep duration to integer values, which likely reflect usual habits in recent times”

  • The paper relies on this without support.

    Residual confounding from unmeasured variables would likely attenuate the association between sleep duration and cardiometabolic disease towards the null.

    “However, this would likely attenuate the association between sleep duration and cardiometabolic disease towards the null”

  • The paper relies on this without support.

    BMI is a useful measure of central obesity and cardiovascular risk.

    “while many studies have shown BMI to be a useful measure of central obesity and cardiovascular risk”

  • The paper relies on this without support.

    BMI does not account for muscle mass, gender- or age-related differences in body fat distribution, or differences in relationships between adiposity and cardiometabolic disease among ethnoracial subgroups.

    “BMI does not account for muscle mass, gender-or age-related differences in body fat distribution, or differences in relationships between adiposity and cardiometabolic disease among ethnoracial subgroups.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The relationship between sleep duration and obesity, diabetes, hypertension and hyperlipidemia depended on self-identified race/ethnicity.

    “This was followed up by another analysis that showed that the relationship between sleep duration and obesity, diabetes, hypertension and hyperlipidemia depended on self-identified race/ethnicity(20).”

    From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [20]

  • Several studies have shown that the relationship between sleep and cardiometabolic disease risk does depend on race/ethnicity.

    “Although this has not yet been directly tested, several studies have shown that the relationship between sleep and cardiometabolic disease risk does depend on race/ethnicity.”

    From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [20]

  • The relationship between sleep and obesity may be moderated by race/ethnicity, with stronger relationships among non-Hispanic white and black/African American adults.

    “Also, this relationship may be moderated by race/ethnicity, with stronger relationships between sleep and obesity among non-Hispanic white and black/African American adults.24”

    From Sleep, Health, and Society (2017) · cites this paper as [24]

  • Sleep duration categories were based on previous data linking sleep duration to cardiometabolic disease risk in a US population sample.

    “based on previous data linking sleep duration to cardiometabolic disease risk in a US population sample [44].”

    From Smoking, screen-based sedentary behavior, and diet associated with habitual sleep duration and chronotype: data from the UK Biobank (2016) · cites this paper as [44]

  • In NHANES analysis, self-reported short sleep duration was associated with both self-reported chronic disease (e.g., obesity and hypertension) and objectively measured markers of chronic disease (e.g., obesity and hyperlipidemia).

    “Analysis of NHANES did find that self-reported short sleep duration was associated with both self-reported chronic disease (e.g. obesity and hypertension) as well as objectively-measured markers of chronic disease (e.g. obesity and hyperlipidemia) [204].”

    From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [204]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Race-specific short-sleep hypertension result conflicts with the abstract

    Major

    The abstract says the association between short sleep and hypertension is strongest among non-Hispanic Whites, Blacks/African-Americans, and non-Mexican Hispanics/Latinos. The stratified results report no elevated outcomes among short sleepers in the first two groups and identify short-sleep hypertension among Mexican-Americans instead.

  • Objective-diabetes interaction is both significant and excluded

    Minor

    The results report a significant sleep-duration-by-race/ethnicity interaction for objective diabetes (p=0.0003), but the discussion says objective diabetes is the exception to race/ethnicity differences.

2 of 2

Cites

Flagged first, then by citations

9 of the 135 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Grandner, 2012, C-reactive protein (CRP) and habitual sleep duration: a complex, non-linear relationship dependent on sex, race/ethnicity, and presence of sleep disorder and/or medical comorbidity, Sleep, 35, A294
  2. Grandner, 2013, Extreme sleep durations and increased C-reactive protein: effects of sex and ethnoracial group, Sleep, 36, 769, 10.5665/sleep.2646 · DOI · Paper page
  3. Whinnery J, Jackson N, Rattanaumpawan P, Grandner MA. Sleep symptoms, race/ethnicity, and socioeconomic position. Sleep, in press.

Cited by

Sorted by citations

Related

Authors
Grandner, M. A., Chakravorty, S., Perlis, M. L., Oliver, L., & Gurubhagavatula, I.
Affiliations
  • University of Pennsylvania (US)
  • Philadelphia VA Medical Center (US)
Corresponding author
Grandner, Michael A.
ORCID
Venue
Sleep Medicine
Publisher
Elsevier BV
Published
2014-01
Volume
15
Issue
1
Pages
42-50
ISSN
1389-9457 (ISSN-L)
DOI
10.1016/j.sleep.2013.09.012
PMC
PMC3947242
OpenAlex
W2038542855
Semantic Scholar
5485cfc73eb7b576de649913112b5fa90a1be2a4
Cited by
300
References
135
Citations by year
2026: 7 · 2025: 19 · 2024: 22 · 2023: 22 · 2022: 29 · 2021: 26 · 2020: 34 · 2019: 31 · 2018: 17 · 2017: 28 · 2016: 21 · 2015: 31 · 2014: 12 · 2013: 1
FWCI
29.35
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Sleep Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • American Heart Association (12SDG9180007)
  • National Heart, Lung and Blood Institute (K23HL110216)
  • National Institute of Environmental Health Sciences (R21ES022931)
  • University of Pennsylvania CTSA (UL1RR024134)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
habitual sleep duration, short sleep duration, long sleep, cardiometabolic risk factors, hypertension, obesity, diabetes mellitus, hyperlipidemia, self-reported sleep duration, racial and ethnic differences, NHANES adults
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Hyperlipidemias, Hypertension, Male, Middle Aged, Nutrition Surveys, Obesity, Surveys and Questionnaires, Risk Factors, Sleep, Sleep Wake Disorders, Racial Groups, Young Adult, Self Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review