Sleep Is Associated with the Metabolic Syndrome in a Multi-Ethnic Cohort of Midlife Women: The SWAN Sleep Study
Open accessAbstract
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.
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While sleep-disordered breathing is strongly associated with metabolic syndrome, the evidence for insomnia is limited and inconsistent.
“While SDB is strongly associated with the metabolic syndrome (MetS), the evidence for insomnia is limited and inconsistent(63, 183, 184).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [63]
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- Authors
- Hall, M. H., Okun, M. L., Sowers, M., Matthews, K. A., Kravitz, H. M., Hardin, K., Buysse, D. J., Bromberger, J. T., Owens, J. F., Karpov, I., & Sanders, M. H.
- Affiliations
- University of Pittsburgh (US)
- University of Michigan (US)
- Rush University Medical Center (US)
- University of California, Davis (US)
- Corresponding author
- Hall, Martica H.
- ORCID
- Venue
- SLEEP
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-06
- Volume
- 35
- Issue
- 6
- Pages
- 783-790
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC3353036
- OpenAlex
- W2049002829
- Cited by
- 123
- References
- 72
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 2 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 4 · 2019: 17 · 2018: 6 · 2017: 7 · 2016: 10 · 2015: 12 · 2014: 11 · 2013: 12 · 2012: 3
- FWCI
- 16.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health (6u01ag012535-26)
- National Institute on Aging (U01-AG-012535, AG012531, U01AG012539, U01AG012505, AG019362, AG 012535, AG012495, AG 012554, U01AG012553, AG019363, U01AG012495, AG019360, AG 012505, R01AG019362, AG 012546, AG019361, AG012553, U01AG012554, R01AG019360, R01AG019361, U01AG012546, R01AG019363, U01AG012531, AG012539)
- National Heart, Lung, and Blood Institute (HL104607, R01HL104607)
- National Institute of Nursing Research (NR-004061, U01NR004061)
- 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
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- metabolic syndrome, middle-aged women, sleep efficiency, sleep fragmentation, sleep continuity, sleep depth, sleep-disordered breathing, apnea-hypopnea index, subjective sleep complaints, racial differences, menopausal status
- MeSH terms
- Analysis of Variance, Asian, Black or African American, Cross-Sectional Studies, Female, Humans, Middle Aged, Sleep, Sleep Apnea Syndromes, Sleep Wake Disorders, United States, Prevalence, Chi-Square Distribution, Logistic Models, Polysomnography, Metabolic Syndrome, White People
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