Sleep Symptoms Predict the Development of the Metabolic Syndrome
Open accessAbstract
BACKGROUND: Sleep complaints are highly prevalent and associated with cardiovascular disease (CVD) morbidity and mortality. This is the first prospective study to report the association between commonly reported sleep symptoms and the development of the metabolic syndrome, a key CVD risk factor. METHODS: Participants were from the community-based Heart Strategies Concentrating on Risk Evaluation study. The sample was comprised of 812 participants (36% African American; 67% female) who were free of metabolic syndrome at baseline, had completed a baseline sleep questionnaire, and had metabolic syndrome evaluated 3 years after baseline. Apnea-hypopnea index (AHI) was measured cross-sectionally using a portable monitor in a subset of 290 participants. Logistic regression examined the risk of developing metabolic syndrome and its components according to individual sleep symptoms and insomnia syndrome. RESULTS: Specific symptoms of insomnia (difficulty falling asleep [DFA] and "unrefreshing" sleep), but not a syndromal definition of insomnia, were significant predictors of the development of metabolic syndrome. Loud snoring more than doubled the risk of developing the metabolic syndrome and also predicted specific metabolic abnormalities (hyperglycemia and low high-density lipoprotein cholesterol). With further adjustment for AHI or the number of metabolic abnormalities at baseline, loud snoring remained a significant predictor of metabolic syndrome, whereas DFA and unrefreshing sleep were reduced to marginal significance. CONCLUSION: Difficulty falling asleep, unrefreshing sleep, and, particularly, loud snoring, predicted the development of metabolic syndrome in community adults. Evaluating sleep symptoms can help identify individuals at risk for developing metabolic syndrome.
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The size and quality of the current body of evidence make it difficult to draw concrete conclusions regarding the association of poor sleep quality with altered lipid metabolism/dyslipidemia.
“Overall, the size and quality of the current body of evidence make it difficult to draw concrete conclusions regarding the association of poor sleep quality with altered lipid metabolism/dyslipidemia.”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [47]
In 812 middle-aged and older adults from the Heart Strategies Concentrating on Risk Evaluation study, loud snoring was associated with an increased risk of low HDL-C.
“In 812 middle-aged and older adults from the communitybased Heart Strategies Concentrating on Risk Evaluation study, loud snoring was associated with an increased risk of low HDL-C, perhaps by snoring related sleep fragmentation or via a sleep disordered breathing-related mechanism.47”
From The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review (2024) · cites this paper as [47]
Previous reports have linked other sleep disorders, such as sleep apnea, with poor health outcomes.
“Previous reports have also linked other sleep disorders, such as sleep apnea, with poor health outcomes (46).”
From Social jetlag, chronotype, and cardiometabolic risk (2015) · cites this paper as [46]
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- Authors
- Troxel, W. M., Buysse, D. J., Matthews, K. A., Kip, K. E., Strollo, P. J., Hall, M., Drumheller, O., & Reis, S. E.
- Affiliations
- University of Pittsburgh (US)
- University of South Florida (US)
- Corresponding author
- Troxel, Wendy M.
- ORCID
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-12
- Volume
- 33
- Issue
- 12
- Pages
- 1633-1640
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2982733
- OpenAlex
- W137944412
- Cited by
- 276
- References
- 32
- Citations by year
- 2026: 4 · 2025: 18 · 2024: 23 · 2023: 19 · 2022: 19 · 2021: 21 · 2020: 19 · 2019: 23 · 2018: 15 · 2017: 21 · 2016: 19 · 2015: 14 · 2014: 17 · 2013: 19 · 2012: 16
- FWCI
- 18.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Pfizer (RR024153)
- GlaxoSmithKline (RR024153)
- Sanofi
- Pennsylvania Department of Health (HL076852, ME-02-384, RR024153)
- Georgia Clinical and Translational Science Alliance
- ResMed
- National Institutes of Health (ME-02-384, HL076852, RR024153)
- National Heart, Lung, and Blood Institute (HL 076858, HL 076852, R24HL076852, K23HL093220, R24HL076858)
- National Center for Research Resources (RR-024153, UL1RR024153)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- sleep symptoms, metabolic syndrome, insomnia, difficulty falling asleep, unrefreshing sleep, apnea-hypopnea index, cardiovascular risk, hyperglycemia, low HDL cholesterol, community-dwelling adults
- MeSH terms
- Aged, Black or African American, Cardiovascular Diseases, Female, Follow-Up Studies, Humans, Male, Middle Aged, Risk Factors, Sex Factors, Sleep Wake Disorders, Metabolic Syndrome, White People
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