Abstract
OBJECTIVES: Insufficient or excessive sleep and dyslipidemia are significant cardiovascular risk factors. Whilst the relationship between sleep duration and traditional lipid indices are well described, the connection to novel lipid and anthropometric indices remains unclear. This study examines these associations using National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2020. METHODS: This cross-sectional study analyzed data from 9847 adults from NHANES 2005-2020, excluding those with major cardiovascular disease and cancer. Sleep duration was categorized as insufficient (< 7 h), normal (7-8 h), and excessive (> 8 h). Self-reported sleep disturbance was documented. Novel indices included non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR), Triglyceride to HDL-Cholesterol (TG/HDL), Triglyceride-Glucose (TyG) Index, Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), Conicity Index (CI), Body-Roundness Index (BRI), A Body Shape Index (ABSI), and Weight-adjusted waist index (WWI). Generalized additive models (GAMs) with spline smoothing and threshold analysis assessed nonlinear associations, adjusting for confounders. Weighted multivariate linear regression evaluated linear associations. RESULTS: Insufficient sleep was associated with higher TyG combined with waist-to-height ratio (TyG-WHtR) (p = 0.003). Excessive sleep was linked to higher TyG-WHtR, CI, BRI, ABSI, and WWI (p < 0.001). Sleep disturbance was associated with elevated TyG-WHtR, TyG-WC, LAP, CI, BRI, ABSI, and WWI (p < 0.001). Threshold analysis confirmed significant changes in several indices, emphasizing the impact of both insufficient and excessive sleep. CONCLUSIONS: Insufficient, excessive sleep duration and sleep disturbance are associated with adverse lipid and anthropometric profiles, indicating increased cardiometabolic risk. Optimal sleep duration and addressing sleep disturbance could mitigate these risks. Further research is needed to understand the underlying mechanisms.