Elsevier

Social Science & Medicine

Volume 71, Issue 5, September 2010, Pages 1027-1036
Social Science & Medicine

Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States

https://doi.org/10.1016/j.socscimed.2010.05.041Get rights and content

Abstract

Research associates short (and to a lesser extent long) sleep duration with obesity, diabetes, and cardiovascular disease; and although 7–8 h of sleep seems to confer the least health risk, these findings are often based on non-representative data. We hypothesize that short sleep (<7 h) and long sleep (>8 h) are positively associated with the risk of obesity, diabetes, hypertension, and cardiovascular disease; and analyze 2004–2005 US National Health Interview Survey data (n = 56,507 observations, adults 18–85) to test this. We employ multilevel logistic regression, simultaneously controlling for individual characteristics (e.g., ethnoracial group, gender, age, education), other health behaviors (e.g., exercise, smoking), family environment (e.g., income, size, education) and geographic context (e.g., census region). Our model correctly classified at least 76% of adults on each of the outcomes studied, and sleep duration was frequently more strongly associated with these health risks than other covariates. These findings suggest a 7–8 h sleep duration directly and indirectly reduces chronic disease risk.

Section snippets

Source of data

We merged the Person, Adult Sample, Household, and Family files of the 2004–2005 US National Health Interview Survey (NHIS: http://www.cdc.gov/nchs/nhis.htm) at the individual level to estimate the association between short or long sleep and obesity, diabetes (type 2), high blood pressure (HBP), or CVD among US residents aged 18–85. Data were collected by approximately 400 interviewers using standard computer-assisted personal interviewing (CAPI) procedures. Although the NHIS attempts to

Results

Approximately one-fourth (24.3%) of all adults who were 18-to-85 years old in the United States in 2004 or 2005 according to NHIS data are estimated to have been obese, and mean body mass index was 27.2 kg/m2 (Table 1). A similar proportion (25.2%) are estimated to have been told by a doctor that they had high blood pressure, about 13% had been told they had a cardiovascular disease, and seven percent had been told they had diabetes. The mean age of all adults was 45 years, almost half were

Discussion

In all models, compared with sleeping 7–8 h/night, both short and long sleep were significantly associated with the probability of obesity, diabetes, HBP, and CVD at the 99% confidence level. Our logistic regression estimates simultaneously control for all variables shown in Table 1 and for sample clustering at the regional level to provide relatively conservative estimates (using robust standard errors). However, NHIS data are cross-sectional and self-reported; thus we are unable to estimate

Acknowledgements

This work was supported by a pilot grant to both authors from the RWJ Health & Society Program, Harvard School of Public Health. For their assistance with the data analysis and manuscript preparation, we thank Louisa Holmes, Keith Malarick, Vanessa Castro, and Andrea Muirhead. Relationships with corporate entities: These relationships have no presumed overlap with this manuscript, did not fund this work, and are not benefited by the manuscript, but are listed in the interest of complete

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