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Table 2 Adjusted prevalence ratios for metabolic abnormalities consistent with metabolic syndrome for pre- and post-menopausal women with poor sleep compared to women with recommended sleep, sister study (2003–2009), N = 38,007

From: Multiple poor sleep characteristics and metabolic abnormalities consistent with metabolic syndrome among white, black, and Hispanic/Latina women: modification by menopausal status

  Total White Black Hispanic
Premenopausal women
Sample size N = 13,988 n = 11,757 n = 1417 n = 814
n (%) with prevalent abnormalities consistent with MetS 787 (5.63) 541 (4.60) 175 (12.4) 71 (8.72)
  PR (95% CI)
Short sleep duration (< 7 h vs. recommended [7–9 h]) 1.23 (1.06–1.42) 1.26 (1.06–1.50) 1.18 (0.89–1.57) NE
Inconsistent weekly sleep patterns (yes vs. no) 1.05 (0.87–1.26) 1.14 (0.90–1.43) 0.98 (0.68–1.40) NE
Sleep debt (yes vs. no) 1.16 (0.99–1.35) 1.16 (0.95–1.42) 0.91 (0.67–1.24) NE
Napping ≥ 3 times/week (yes vs. no) 1.25 (1.01–1.56) 1.18 (0.90–1.56) 1.35 (0.91–1.98) NE
Insomnia symptoms (yes vs. no) 1.21 (1.05–1.41) 1.10 (0.91–1.33) 1.32 (0.99–1.75) NE
 Difficulty falling asleep (yes vs. no) 1.11 (0.93–1.32) 1.05 (0.83–1.32) 1.13 (0.82–1.56) NE
 Difficulty staying asleep (yes vs. no) 1.33 (1.11–1.59) 1.21 (0.97–1.51) 1.52 (1.06–2.18) NE
Short sleep and insomnia symptoms (yes vs. no) 1.25 (1.04–1.50) 1.17 (0.91–1.50) 1.28 (0.94–1.75) NE
Cumulative sleep score 1.10 (1.04–1.16) 1.10 (1.03–1.17) 1.08 (0.96–1.20) NE
Postmenopausal women
Sample size N = 24,019 n = 21,168 n = 1826 n = 1025
n (%) with prevalent abnormalities consistent with MetS 3725 (15.5) 2998 (14.2) 514 (28.2) 213 (20.8)
  PR (95% CI)
Short sleep duration (< 7 h vs. recommended [7–9 h]) 1.09 (1.02–1.16) 1.09 (1.01–1.17) 1.05 (0.91–1.22) 1.23 (0.97–1.55)
Inconsistent weekly sleep patterns (yes vs. no)B 1.23 (1.15–1.31) 1.26 (1.17–1.36) 1.11 (0.94–1.30) 1.17 (0.89–1.53)
Sleep debt (yes vs. no) 1.24 (1.14–1.35) 1.25 (1.13–1.38) 1.15 (0.96–1.39) 1.21 (0.91–1.62)
Napping ≥ 3 times/week (yes vs. no) 1.27 (1.18–1.37) 1.27 (1.16–1.39) 1.34 (1.13–1.58) 1.17 (0.88–1.55)
Insomnia symptoms (yes vs. no) 1.11 (1.05–1.18) 1.12 (1.05–1.21) 1.00 (0.86–1.16) 1.25 (0.97–1.61)
 Difficulty falling asleep (yes vs. no) 1.11 (1.04–1.19) 1.14 (1.05–1.23) 1.02 (0.87–1.20) 1.10 (0.84–1.42)
 Difficulty staying asleep (yes vs. no)B 1.07 (0.99–1.16) 1.08 (0.99–1.17) 0.91 (0.73–1.13) 1.38 (1.06–1.81)
Short sleep and insomnia symptoms (yes vs. no)A 1.12 (1.03–1.21) 1.17 (1.07–1.28) 0.92 (0.77–1.10) 1.20 (0.91–1.59)
Cumulative sleep scoreB 1.11 (1.08–1.13) 1.11 (1.08–1.14) 1.07 (1.01–1.13) 1.14 (1.04–1.25)
  1. Pshort sleep*menopausal status = 0.0070; Pconsistent sleep*menopausal status = 0.71; Psleep debt*menopausal status = 0.27; Pnapping*menopausal status = 0.38; Pinsomnia symptoms*menopausal status = 0.035; Pdifficulty falling asleep*menopausal status = 0.32; Pdifficulty staying asleep*menopausal status = 0.0074; Pshort sleep and insomnia symptoms*menopausal status = 0.027; Psleep score *menopausal status = 0.15
  2. Adjusted for age at baseline (years), educational attainment (≤ high school graduate/graduation equivalent degree, some college/technical school/associate’s degree, ≥ college graduate), annual household income (< $20,000, $20,000–$49,999, $50,000–$99,999, ≥ $100,000), diet quality (Healthy Eating Index score [38]), physical activity (METs [metabolic equivalent] hours per week), use of hormone replacement therapy (yes vs. no), alcohol consumption (nondrinker [former/never], light/moderate [≤ 7 drinks/week], heavy [> 7 drinks/week]), smoking status (never, former, current), clinical depression or bipolar disorder (yes vs. no), and sleep medication use (yes vs. no). Models for sleep debt are also adjusted for consistent weekly sleep patterns (no vs. yes)
  3. Inconsistent weekly sleep patterns indicated whether participants reported consistent (could vary day-by-day but were stable from week-to-week) or inconsistent wake-up times and bedtimes during the prior 6 weeks. Sleep debt was defined as ≥ 2-h difference between average longest and shortest sleep duration. Insomnia symptoms included difficulty falling asleep, defined as taking > 30 min vs. ≤ 30 min to fall asleep on average, or difficulty staying asleep, defined as waking up ≥ 3 times per night ≥ 3 nights/week vs. < 3 times per night < 3 nights/week vs. neither. Cumulative sleep score was the sum of yes responses to the main sleep characteristics (short sleep duration, inconsistent weekly sleep patterns, sleep debt, frequent napping, and insomnia symptoms [range: 0–5])
  4. < 0.2% missingness for sleep medication use, habitual sleep duration category, consistent sleep pattern, sleep debt, napping, insomnia symptoms, difficulty falling asleep, difficulty staying asleep, cumulative sleep score
  5. MetS metabolic syndrome, PR prevalence ratio, CI confidence interval, h hours, NE not estimable
  6. Italic values indicate statistical significance at two-sided p = 0.05
  7. Ap < 0.05 for interaction term (sleep variable by race/ethnicity)
  8. Bp < 0.10 for interaction term (sleep variable by race/ethnicity)