Abstract P069: Association Between Habitual Sleep Duration and Cardiometabolic Disease, and the Mediating Role of Foregoing Care: Data From the 2013 Behavioral Risk Factor Surveillance System
Introduction: Sleep duration is associated with cardiometabolic disease risk, as well as lower socioeconomic position. Shorter sleepers may be at increased risk of adverse outcomes due to the myriad pathophysiologic consequences of decreased sleep, but also partially because social/financial pressures that may lead to less health care use, interact with physiologic risks, and result in under-treatment of conditions that may lead to chronic disease.
METHODS: The 2013 BRFSS was used (N=483,495 adults). Sleep duration was assessed by a survey item of 24h habitual sleep. Responses were categorized as very short (<5h), short (5-6h), normal (7-8h, ref), and long (≥9h). Participants indicated if they did not receive medical care due to cost within the past 12 months, as well as obesity (BMI≥30) and history of diabetes, hypertension, hypercholesterolemia, coronary heart disease, myocardial infarction, or stroke. Covariates included age, sex, race/ethnicity, education, income, smoking, and BMI (except for obesity analyses). Weighted logistic regression analyses examined relationships with health outcomes. The Baron and Kenny model was used for mediation and Sobel tests for partial mediation.
RESULTS: See Table. Very short, short, and long sleep were associated with all assessed health outcomes. Foregoing healthcare due to cost was more likely to occur among very short (OR=2.68, 95%CI=2.47-2.90, p<0.001) and short sleepers (OR=1.70, 95%CI=1.63-1.78, p<0.001), but not long sleepers (p=0.89). In mediation analyses, foregoing care explained 6-14% of the relationship between very short and short sleep duration and cardiometabolic disease history.
CONCLUSIONS: Habitual sleep duration is associated with prevalent cardiometabolic disease. Very short and short sleep duration are associated with foregoing medical care, which partially explains the relationship with cardiometabolic disease. This suggests that a non-physiologic pathway (reduced medical care) may play a role in the relationship of sleep to chronic disease.
Author Disclosures: M.A. Grandner: None. M. Petrov: None. S. Chakravorty: None. S. Bhatt: None. I. Gurubhagavatula: None.
- © 2015 by American Heart Association, Inc.