Association of sleep timing, sleep duration, and sleep latency with metabolic syndrome in middle-aged adults in Korea: A cross-sectional and longitudinal study

Objective: Sleep is a potential risk factor for metabolic syndrome. We investigated the associations of various sleep characteristics with the status and incidence of metabolic syndrome in middle-aged Koreans. Methods: Using data from a community-based Korean Medicine Daejeon Citizen Cohort study on participants aged 30-50 years, cross-sectional (n = 1984) and longitudinal (n = 1216, median follow-up: 2.1 years) analyses were performed. To study the association of metabolic syndrome and five components with various sleep characteristics, measured using the Pittsburgh Sleep Quality Index, we used Poisson and logistic regression and Cox proportional hazard regression analyses, adjusting for covariates. Results: Of 1984 participants, 66%, 19%, and 15% belonged to the non-metabolic syndrome, pre-metabolic syndrome, and metabolic syndrome groups, respectively. After covariate adjustments, the pre-metabolic syndrome group was associated with late mid-sleep time (>= 5:0 0; prevalence ratios 1.61, 95% confidence interval 1.01-2.54) and late bedtime (>= 2:0 0; prevalence ratios 1.55, 95% confidence interval 1.03-2.34), and the metabolic syndrome group was associated with long sleep latency (prevalence ratios 1.33, 95% confidence interval 1.03-1.73), poor sleep quality (prevalence ratios 1.38, 95% confidence interval 1.07-1.78), and early wake time (< 6:00; prevalence ratios 1.29, 95% confidence interval 1.01-1.63). Longitudinal analysis of participants without metabolic syndrome at baseline indicated a significant increase in metabolic syndrome risk associated with very short sleep duration (< 6 hours; hazard ratio 1.72, 95% confidence interval 1.062.79), long sleep latency (> 30 minutes; hazard ratio 1.86, 95% confidence interval 1.1-3.12), and early wake time (< 6:00 o'clock; hazard ratio 1.73, 95% confidence interval 1.01-2.97). Conclusion: Sleep characteristics, such as short duration, long latency, and early wake time, were associated with an increased risk of metabolic syndrome in middle-aged adults. (c) 2024 The Author(s). Published by Elsevier Inc. on behalf of National Sleep Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).