Cited by 88Sleep and related disordersSleep and Work-Related FatigueCircadian rhythm and melatonin

Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease?

Open access
Grandner, Michael A.·2014·International Review of Psychiatry

Abstract

There is increasing awareness of the role of sleep disturbance as an important factor in health and disease. Although sub-clinical sleep disturbances (insufficient sleep duration or inadequate sleep quality) may be difficult to assess with conceptual and/or methodological clarity, this review attempts to summarize and synthesize these findings. First, the concept of sleep disturbance in a public health context is introduced, to provide context and rationale. Second, operational definitions of 'cardiometabolic disease' and 'sleep disturbance' are offered, to address many unclear operationalizations. Third, the extant literature is summarized regarding short or long sleep duration and/or insufficient sleep, insomnia and insomnia symptoms, general (non-specific sleep disturbances), circadian rhythm abnormalities that result in sleep disturbances, and, briefly, sleep-disordered breathing. Fourth, the review highlights the social/behavioural context of sleep, including discussions of sleep and race/ethnicity, socio-economic position, and other social/environmental factors, in order to place these findings in a social-environmental context relevant to public health. Fifth, the review highlights the issue of sleep as a domain of health behaviour and addresses issues regarding development of healthy sleep interventions. Finally, a research agenda of future directions is proposed.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review synthesizes evidence linking sleep disturbances—short/long sleep, insomnia, poor sleep quality, circadian disruption, and sleep-disordered breathing—to cardiometabolic disease risk. It argues that sleep should be treated as a public-health behaviour and proposes a social-ecological framework and research agenda, though causal and intervention evidence remains limited.

Key findings

  • Short and long sleep duration have been associated with increased mortality across approximately 50 years and approximately 50 studies; short sleep is linked to obesity, diabetes, hypertension, dyslipidemia, inflammation, heart attack, and stroke, while long sleep shows mixed but adverse associations.
  • In a meta-analysis, insomnia overall was associated with a 5% increased risk of incident hypertension; middle insomnia was associated with a 20% increased risk and late insomnia with a 14% increased risk. Among >85,000 women in the Women’s Health Initiative, insomnia symptoms were associated with a 19% increased risk of coronary heart disease and an 11% increased risk of cardiovascular events.
  • General sleep disturbance in the 2006 BRFSS was associated with a 35% increased risk of obesity, 54% increased risk of diabetes, 80% increased risk of heart attack, 102% increased risk of stroke, and 98% increased risk of any coronary artery disease; relationships attenuated after adjustment, and diabetes/stroke were no longer significant when overall physical health was entered.
  • Social patterning was inconsistent: in NHANES 2007–2008, Black/African-American adults were 58% more likely to report sleep latency >30 min, but less likely to report difficulty falling asleep (OR = 0.57), as were Mexican-Americans (OR = 0.59) and other Hispanics/Latinos (OR = 0.73).

Methods

  • Narrative review, not a systematic review or meta-analysis; it synthesizes existing epidemiologic and clinical literature on operational definitions of cardiometabolic disease and sleep disturbance, including short/long sleep, insufficient sleep, insomnia, general sleep disturbance, circadian rhythm abnormalities, and sleep-disordered breathing.
  • Discusses social/behavioural context (race/ethnicity, socio-economic position, environment), conceptualizes sleep as a domain of health behaviour using a social-ecological model, reviews health behaviour change models, and proposes a future research agenda. No primary data collection or formal meta-analysis was conducted by the author.

Limitations

  • Stated: “sleep disturbance” is non-specific and difficult to assess with conceptual and methodological clarity; most epidemiologic studies use non-standardized survey items, retrospective/subjective measures, and cross-sectional designs, limiting causal inference.
  • Stated: there are no intervention studies for general sleep disturbance, and no studies investigating whether insomnia treatment improves cardiometabolic outcomes; sleep apnoea treatment has some evidence for improved cardiovascular outcomes.
  • Evident from the text: as a narrative review, it does not describe a systematic search strategy or formal quality appraisal, so conclusions rely on cited literature and may be subject to selection or reporting bias.

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

Integrity signals

Registry

Crossref · 10.3109/09540261.2014.911148

Cites

339 of 339 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 138 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    Long sleep duration is associated with presence of cardiovascular disease in general.

    “presence of cardiovascular disease in general (Buxton & Marcelli, 2010; Cappuccio et al., 2011)”
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    • cites Buxton & Marcelli, 2010

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    • cites Cappuccio et al., 2011

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    Short sleep duration is associated with obesity-related outcomes, including incident weight gain, incident obesity, current body mass index, and current adiposity.

    “short sleep duration has been associated with obesity-related outcomes, diabetes-related outcomes, and cardiovascular-related outcomes. Regarding obesity-related outcomes, short sleep duration has been associated with incident weight gain (Kobayashi et al., 2012; Nagai et al., 2013), incident obesity (Watanabe et al., 2010), current body mass index (Patel, 2009), and current adiposity(Chaput et al”
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    • cites Kobayashi et al., 2012 source

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    • cites Nagai et al., 2013 source

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    Long sleep duration is associated with stroke.

    “stroke (Altman et al., 2012; Kakizaki et al., 2013)”
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    • cites Altman et al., 2012 source

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  • Interpretationcitation

    Both short and long sleep duration are associated with increased mortality risk.

    “For approximately 50 years and across approximately 50 studies, both short and long sleep duration have been associated with increased mortality risk (Cappuccio et al., 2010; Gallicchio & Kalesan, 2009; Grandner et al., 2010c).”
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    • cites Grandner et al., 2010c

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  • Premisecitation

    Long sleep duration is associated with diabetes.

    “diabetes (Buxton & Marcelli, 2010; Kachi et al., 2012)”
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    • cites Buxton & Marcelli, 2010

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    • cites Kachi et al., 2012 source

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    Premisecitation

    Short sleep duration is associated with cardiovascular-related outcomes, including incident hypertension, current hypertension, dyslipidemia, atherosclerosis risk factors, inflammation, cardiovascular disease in general, history of heart attack, and stroke.

    “Regarding cardiovascular-related outcomes, short sleep duration has been associated with incident hypertension (Cappuccio et al., 2011; Meng et al., 2013), current hypertension (Altman et al., 2012; Fang et al., 2012; Faraut et al., 2012b; Grandner et al., 2014a; Wang et al., 2012), dyslipidemia (Altman et al., 2012; Gangwisch et al., 2010a; Grandner et al., 2014a), atherosclerosis risk factors (”
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    • cites Cappuccio et al., 2011

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    • cites Meng et al., 2013 source

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    Premisecitation

    Short sleep duration is associated with diabetes-related outcomes, including diabetes, insulin and/or glucose dysregulation, and dysregulation of metabolic hormones.

    “Regarding diabetes-related outcomes, short sleep duration has been associated with diabetes (Buxton & Marcelli, 2010; Grandner et al., 2014a; Hsieh et al., 2011; Kachi et al., 2012), insulin and/or glucose dysregulation (Beihl et al., 2009; Byberg et al., 2012; Chang et al., 2012b; Chaput et al., 2009; Javaheri et al., 2011; Liu et al., 2011; Lucassen et al., 2012; Zuo et al., 2012), and dysre”
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    • cites Buxton & Marcelli, 2010

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    • cites Grandner et al., 2014a

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    Premisecitation

    Sleep apnoea often presents as daytime sleepiness or non-restorative sleep and sometimes as insomnia.

    “sleep apnoea often presents as daytime sleepiness or non-restorative sleep (Alam et al., 2012; Cruz et al., 2012; Lal et al., 2012; Lee et al., 2012; Sunwoo et al., 2012) and sometimes as insomnia (Al-Jawder & Bahammam, 2012; Glidewell et al., 2012).”
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    • cites Alam et al., 2012 source

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    • cites Lal et al., 2012 source

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    Premisenone given

    Insomnia and its symptoms are strongly related to mental health outcomes.

    “Insomnia and its symptoms are strongly related to mental health outcomes, but cardiometabolic relationships have just recently been explored.”
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    Premisecitation

    Sleep apnoea is associated with significant sleep fragmentation.

    “Sleep apnoea is associated with significant sleep fragmentation (Bianchi et al., 2012)”
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    Premisecitation

    Reporting any activity was associated with a decreased likelihood of reporting sleep disturbance (around 30% decrease) and daytime tiredness (around 50% decrease).

    “simply reporting any activity was associated with a decreased likelihood of reporting sleep disturbance (around 30% decrease) and daytime tiredness (around 50% decrease).”
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    • cites Grandner et al., 2011 source

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    Premisenone given

    Sleep-disordered breathing, especially untreated obstructive sleep apnoea, is a well-known cardiometabolic risk factor associated with cardiac and vascular outcomes, diabetes, and mortality.

    “Sleep-disordered breathing, especially (untreated) obstructive sleep apnoea, is a well-known cardiometabolic risk factor, associated with cardiac and vascular outcomes, diabetes, and mortality.”
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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Long sleep duration and perceived insufficient sleep have not been studied as thoroughly as short sleep duration.

    “Long sleep duration and perceived insufficient sleep, however, have not been studied as thoroughly.”
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    Premisenone given

    Cardiometabolic relationships of insomnia have just recently been explored.

    “Insomnia and its symptoms are strongly related to mental health outcomes, but cardiometabolic relationships have just recently been explored.”
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    Premisecitation

    Short sleep duration moderates the effect of long working hours on coronary heart disease risk, with those sleeping less than 6 h on average being at the highest risk.

    “Notably, short sleep duration in this group was found to be a significant moderator of the effect, with those sleeping < 6 h on average being at the highest risk.”
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    • cites Cheng et al., 2014 source

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    Premisecitation

    Shiftwork is implicated in diabetes, ischaemic heart disease, and metabolic syndrome.

    “a recent review by Szosland summarizes data that implicates shiftwork in diabetes, ischaemic heart disease, and metabolic syndrome (Szosland, 2010).”
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    • cites Szosland, 2010 source

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    Premisecitation

    General sleep disturbance, assessed as difficulty falling asleep, staying asleep, or sleeping too much in at least 7 of the past 14 days, is associated with a 35% increased risk of obesity, a 54% increased risk of diabetes, an 80% increased risk of heart attack, a 102% increased risk of stroke, and a 98% increased risk of any coronary artery disease.

    “Grandner and colleagues found that sleep disturbance, assessed as difficulty falling asleep, staying asleep, or sleeping too much in at least 7 of the past 14 days (assessed using the 2006 BRFSS), was associated with a 35% increased risk of obesity, a 54% increased risk of diabetes, an 80% increased risk of heart attack, a 102% increased risk of stroke, and a 98% increased risk of any coronary”
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    • cites Grandner et al., 2012a

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    Interpretationcitation

    The risks of sleep apnoea are probably largely due to intermittent hypoxia and co-morbid obesity.

    “though the risks are probably largely due to the intermittent hypoxia and co-morbid obesity (Pak et al., 2014).”
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    • cites Pak et al., 2014 source

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    Premisecitation

    After adjustment for demographics, socio-economics, mental health, healthcare access, smoking, alcohol use and BMI, the relationships between general sleep disturbance and outcomes remained significant though attenuated, except for obesity.

    “All of these relationships remained significant (though attenuated) after adjustment for demographics, socio-economics, mental health, healthcare access, smoking, alcohol use and BMI (for outcomes other than obesity).”
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    • cites Grandner et al., 2012a

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    Premisecitation

    Circadian adaptation to night work results in improved sleep, improved performance, and improved heart rate variability.

    “Boudreau and colleagues found that circadian adaptation to night work resulted in improved sleep, improved performance, and improved heart rate variability (Boudreau et al., 2013).”
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    • cites Boudreau et al., 2013 source

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    Premisecitation

    The burden of chronic health conditions such as obesity, diabetes, and hypertension is disproportionately borne by racial/ethnic minorities and those of lower socio-economic position.

    “The burden of chronic health conditions such as obesity, diabetes, and hypertension are disproportionately borne by racial/ethnic minorities and those of lower socio-economic position (Centers for Disease Control and Prevention, 2011).”
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    • cites Centers for Disease Control and Prevention, 2011

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    Interpretationnone given

    Circadian rhythm problems can predispose individuals to adverse outcomes, especially when accompanied by long work hours.

    “Circadian rhythm problems can also predispose individuals to adverse outcomes, especially when accompanied by long work hours.”
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    Premisecitation

    Insomnia symptoms are associated with a 19% increased risk of coronary heart disease and an 11% increased risk of cardiovascular events in women.

    “They found that in fully adjusted models, insomnia symptoms were associated with a 19% increased risk of coronary heart disease and an 11% increased risk of cardiovascular events.”
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    • cites Sands-Lincoln et al., 2013b

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    Premisecitation

    The only non-poor group to differ from the non-poor white group was non-poor black/African-Americans, who had worse sleep overall, but to a lesser degree than their poor counterparts.

    “The only non-poor group to differ from the non-poor white group was non-poor black/African-Americans, who had worse sleep overall, but to a lesser degree than their poor counterparts.”
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    • cites Patel et al., 2010

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    Premisecitation

    In those adjusted models, difficulty maintaining sleep, early morning awakenings, non-restorative sleep, and daytime sleepiness were all reported less frequently among black/African-Americans and Mexican-Americans.

    “Similarly, difficulty maintaining sleep, early morning awakenings, non-restorative sleep, and daytime sleepiness were all reported less frequently among black/African-Americans and Mexican-Americans”
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    • cites Grandner et al., 2013d

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    Premisecitation

    Within racial groups, different factors predicted shorter sleep: stress and education played a larger role in non-Hispanic white adults, and inflammation played a larger role in black/African-American adults.

    “within groups, different factors predicted shorter sleep, with stress and education playing a larger role in the non-Hispanic white group, and inflammation playing a larger role in the black/African-American group.”
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    • cites Gamaldo et al., 2013a

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    Premisecitation

    In those adjusted models, self-reported difficulty falling asleep was reported less frequently among black/African-Americans (OR=0.57), Mexican-Americans (OR=0.59), and other Hispanics/Latinos (OR=0.73).

    “self-reported difficulty falling asleep was reported less frequently among black/ African-Americans (odds ratio (OR) = 0.57), Mexican-Americans (OR = 0.59), and other Hispanics/ Latinos (OR = 0.73).”
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    • cites Grandner et al., 2013d

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    Study design and conductcitation

    The 2007-2008 NHANES analysis by Grandner et al. adjusted for age, sex, race/ethnicity, marital status, immigrant status, income, education, access to health insurance, and household food security.

    “In models that included age, sex, race/ethnicity, marital status, immigrant status, income, education, access to health insurance, and household food security, the following results were found.”
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    • cites Grandner et al., 2013d

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    Premisecitation

    In those adjusted models, non-Mexican Hispanics/Latinos were more likely to report choking/gasping during sleep and snoring.

    “The non-Mexican Hispanics/Latinos were more likely to report choking/gasping during sleep and snoring, however.”
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    • cites Grandner et al., 2013d

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    Premisecitation

    Other studies have failed to find an association between minority status and overall sleep quality.

    “whereas others have failed to find this association (Gellis et al., 2005; Grandner et al., 2010b; Hale & Rivero-Fuentes, 2011).”
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    • cites Gellis et al., 2005 source

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    • cites Grandner et al., 2010b

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    • cites Hale & Rivero-Fuentes, 2011

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  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The social-ecological model has implications for the development of interventions to address sleep and health.

    “This model also has implications for the development of interventions to address sleep and health.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Geography explains sleep disturbance and insufficient sleep in the US.

    “recent studies have shown that geography explains sleep disturbance (Grandner et al., 2012b) and insufficient sleep (Grandner et al., 2013f) in the US.”
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    • cites Grandner et al., 2012b

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    • cites Grandner et al., 2013f

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    Premisecitation

    In Grandner et al. 2013d, non-restorative sleep, sleepiness, snorting/gasping, and snoring were all associated with lower education levels and lower food security.

    “Non-restorative sleep, sleepiness, snorting/gasping and snoring were all associated with lower education levels and lower food security.”
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    • cites Grandner et al., 2013d

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    Interpretationreasoning

    Societal-level factors such as globalization, technology, and 24/7 society play a role in shaping social and eventually individual attitudes, beliefs, and practices regarding sleep.

    “The model even goes further to recognize that even these social-level factors exist in the context of larger, societal-level factors such as globalization, technology, 24/7 society, and others, which play a role in shaping social and eventually individual attitudes, beliefs, and practices regarding sleep.”
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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisereasoning

    Health behaviour change models are necessary because unhealthy behaviours such as poor diet, sedentary lifestyle, and smoking are complex and resistant to change.

    “These models are necessary because unhealthy behaviours (such as poor diet, sedentary lifestyle, smoking) are complex and resistant to change.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Unhealthy behaviours such as poor diet, sedentary lifestyle, and smoking are complex and resistant to change.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A social-ecological model of sleep and health was recently proposed by our group, based on Bronfenbrenner's social-ecological theory.

    “With this in mind, a social-ecological model of sleep and health was recently proposed by our group (Grandner et al., 2010c), based on the social-ecological theory of Bronfenbrenner (1977).”
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    • cites Grandner et al., 2010c

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    • cites Bronfenbrenner (1977) source

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    Premisecitation

    In Grandner et al. 2013d, sleep latency > 30 min was associated with less than a college education, no access to private health insurance, and marginal, low, or very low food security.

    “sleep latency > 30 min was associated with less than a college education, no access to private health insurance, and marginal, low, or very low food security.”
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    • cites Grandner et al., 2013d

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Premisenone given

    The data needed to frame insufficient sleep as important and relevant has only been recently aggregated in a way that makes the case compelling.

    “One potential reason is that the data needed to frame this form of sleep as important and relevant has only been recently aggregated in a way that makes the case compelling.”
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    Premisecitation

    The health belief model states that individuals will alter their behaviour based on perceived risk, perceived benefits, perceived barriers, perceived ability, and cues to action.

    “Briefly, the health belief model (Champion & Skinner, 2008; Rosenstock, 1966) states that individuals will alter their behaviour based on (1) perceived risk of maintaining existing behaviour, (2) perceived benefits of the new behaviour, (3) perceived barriers in engaging in the new behaviour, (4) perceived ability to carry out the behaviour, and (5) cues to action (reminders).”
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    • cites Champion & Skinner, 2008

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    • cites Rosenstock, 1966

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    Premisecitation

    The transtheoretical model dictates that interventions based on action should only be implemented by those who are ready to engage in that action.

    “The model dictates that interventions based on action should only be implemented by those who are ready to engage in that action.”
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    • cites Prochaska & DiClemente, 1982 source

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  • May combine two claims.

    Premisenone given

    Regarding insomnia, there are several studies showing associations with cardiometabolic disease, but there are still no studies investigating whether insomnia treatment improves cardiometabolic outcomes.

    “Regarding insomnia, although there are several studies showing associations with cardiometabolic disease, there are still no studies investigating whether insomnia treatment improves cardiometabolic outcomes.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    If sleep shares characteristics with other health behaviours, it is reasonable to suspect that a sleep intervention could have lasting impact.

    “Despite this, if sleep shares characteristics with other health behaviours, it is reasonable to suspect that a sleep intervention could have lasting impact.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationnone given

    Less data is available for insomnia without short sleep, circadian-rhythm disorders, and general poor sleep quality, though there are a number of studies to suggest that these, too, may be associated with cardiometabolic disease.

    “Less data is available for insomnia without short sleep, circadian-rhythm disorders, and general poor sleep quality, though there are a number of studies to suggest that these, too, may be associated with cardiometabolic disease.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Interpretationreasoning

    If a sleep-based intervention can improve cardiometabolic health risk factors or outcomes, this would lend further support to the notion that sleep changes are causally related to changes in cardiometabolic health.

    “If a sleep-based intervention can improve cardiometabolic health risk factors or even outcomes, this would lend further support to the notion that sleep changes are causally related to changes in cardiometabolic health.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    This conceptualization may be useful in framing the role of sleep in health and may also aid in the development of some of the first interventions for poor sleep at the population level.

    “This conceptualization may be useful in framing the role of sleep in health and may also aid in the development of some of the first interventions for poor sleep at the population level.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Sleep represents an important issue for public health.

    “Overall, though, sleep represents an important issue for public health.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Evidence that minority status and lower socio-economic position is associated with poor sleep represents the majority of this literature.

    “In particular, evidence that minority status and lower socio-economic position is associated with poor sleep represents the majority of this literature.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Sleep likely represents a major domain of health behaviour.

    “Sleep likely represents a major domain of health behaviour.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    These relationships seem to generally remain consistent across domains, suggesting the importance of sleep in regulating cardiometabolic function.

    “These relationships seem to generally remain consistent across domains, suggesting the importance of sleep in regulating cardiometabolic function.”
    Quote in the paperSubstantial claim
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  • The paper relies on this without support.

    Cardiometabolic disease can be postponed or prevented using lifestyle behavioural approaches that would likely include healthy sleep.

    “Since cardiometabolic disease can be postponed or prevented using lifestyle behavioural approaches (that would likely include healthy sleep), these are the focus of this review.”
  • The paper relies on this without support.

    For epidemiological data collections, general sleep disturbance has generally been the only way to assess sleep at a population level.

    “For epidemiological data collections, this has generally been the only way to assess sleep at a population level.”
  • The paper relies on this without support.

    Sleep disturbances are prevalent.

    “Given that these sleep disturbances are prevalent and are associated with important clinical outcomes, it is important to consider the broader public health implications.”
  • The paper relies on this without support.

    Unhealthy behaviours such as poor diet, sedentary lifestyle, and smoking are complex and resistant to change.

    “These models are necessary because unhealthy behaviours (such as poor diet, sedentary lifestyle, smoking) are complex and resistant to change.”
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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?

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.

  • Conflicting thresholds for the same sleep-disturbance measure

    Minor

    The paper describes the Grandner et al. (2012a) sleep-disturbance measure as requiring symptoms on at least 6 of 14 days in one section, but at least 7 of the past 14 days in another.

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Cites

Flagged first, then by citations

5 of the 344 references couldn’t be matched to a known paper.

Research works printed but not linked: 15

  1. Aurora R.N., 2012, Sleep, 35, 1039
  2. Besteiro Gonzalez J.L., 2011, Psicothema, 23, 368
  3. Gamaldo A.A., 2013, Journal of Gerontology B: Psycholical Science and Social Science
  4. Gehrman P.R., 2010, Principles and Practice of Geriatric Sleep Medicine, 384
  5. Grandner M.A., 2013, Journal of Clinical Sleep Medicine, 9, 897, 10.5664/jcsm.2990 · DOI · Paper page
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Cited by

Sorted by citations

Authors
Grandner, M. A.
Affiliations
University of Pennsylvania (US)
Corresponding author
Grandner, Michael A.
Venue
International Review of Psychiatry
Published
2014-04
Volume
26
Issue
2
Pages
155-176
ISSN
  • 0954-0261 (ISSN-L)
  • 1369-1627
OpenAlex
W2163768179
Cited by
88
References
344
Citations by year
2026: 1 · 2025: 8 · 2024: 7 · 2023: 4 · 2022: 16 · 2021: 7 · 2020: 10 · 2019: 8 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 9
FWCI
0.99
Type
journal article
Language
en
Open access
Locations
  • International Review of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000003)
  • National Heart, Lung, and Blood Institute (K23HL110216)
  • National Institute of Environmental Health Sciences (R21ES022931)
  • National Center for Research Resources (UL1RR024134)
  • National Center for Advancing Translational Sciences
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
sleep disorders, cardiometabolic disease, insufficient sleep duration, sleep quality, insomnia, circadian rhythm disruption, sleep-disordered breathing, race and ethnicity, socioeconomic status, prevention
MeSH terms
Cardiovascular Diseases, Diabetes Mellitus, Humans, Obesity, Risk Factors, Sleep Apnea Syndromes, Sleep Wake Disorders, Socioeconomic Factors

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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.

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