Sleep is associated with the metabolic syndrome in a multi-ethnic cohort of midlife women: the SWAN Sleep Study

Sleep. 2012 Jun 1;35(6):783-90. doi: 10.5665/sleep.1874.


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.

Keywords: Sleep; metabolic syndrome; midlife women; obesity; race.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analysis of Variance
  • Asian
  • Black or African American
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / physiopathology
  • Middle Aged
  • Polysomnography
  • Prevalence
  • Sleep / physiology
  • Sleep Apnea Syndromes / complications
  • Sleep Apnea Syndromes / epidemiology
  • Sleep Apnea Syndromes / physiopathology
  • Sleep Wake Disorders / complications*
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / physiopathology
  • United States / epidemiology
  • White People