Associations between self-reported and actigraphy measured sleep duration with metabolic syndrome: evidence from NHANES 2011–2014

We used a nationally representative dataset to examine the associations between self-reported and actigraphy-measured sleep duration and a continuous metabolic syndrome (MetS) severity score in the United States population. We analyzed cross-sectional data from the national and nutrition examination survey (NHANES) 2011–2014 cycles. Our sample included adults (≥ 20 years) with complete data on sleep, sociodemographic, and MetS-related variables (N = 3245). A composite MetS severity score (MetSSS) was created using measures of waist circumference, fasting glucose, blood pressure, HDL cholesterol, and triglycerides. Actigraphy-measured sleep duration was obtained from accelerometer data collected across 7 days. Self-reported sleep duration was obtained using a one-time single question. The association between sleep duration and MetSSS was examined using linear regression models adjusting for relevant confounders. Self-reported short sleep duration (but not long), and actigraphy-measured long sleep duration (but not short) predicted greater MetSSS (b = 0.21, p < .001 and b = 0.33, p < .001, respectively), when adjusting for sociodemographic factors (age, sex, race/ethnicity, education, income, food insecurity, and health insurance status). However, after covarying for depression, sedentary behavior, sleep disturbances, and diet, only actigraphy measured long sleep duration remained significantly associated with MetS. Both short and long sleep duration may increase the severity of metabolic syndrome. However, the association between short sleep duration and metabolic syndrome may be confounded by other variables (e.g., health behaviors, sleep quality, mood). Research and clinical implications of these results are discussed.