Associations between self-reported sleep duration and cardiometabolic risk factors in young African-origin adults from the five-country Modeling the Epidemiologic Transition Study (METS)

Objectives: To investigate associations between self-reported sleep duration and cardiometabolic (CM) risk factors in African-origin adults residing in five countries spanning the epidemiologic transition. Design: Cross-sectional Setting and participants: Ghanaian (n=491), South African (n=503), Jamaican (n=508), Seychellois (n=501) and American (n=480) men and women. Measurements: Self-reported sleep duration was obtained using questionnaires. Sex- and agesite-stratified logistic regression analyses investigated relationships between sleep duration, individual CM risk factors and a binary CM risk variable (presence of ≥3 CM risk factors), adjusting for age, physical activity and education. Results: Sleep duration distributions varied by cohort: 44.5%, 41.4%, 35.9%, 16.8% and 2.5% of American, Jamaican, Seychellois, Ghanaian and South African men reported <7h sleep per night respectively (p<0.001). Similarly, 42.6%, 28.6%, 25.2%, 12.8% and 1.5% of American, Jamaican, Seychellois, Ghanaian and South African women reported <7h sleep respectively (p<0.001). American men reporting ≤6h sleep were more likely to be in the elevated CM risk group (OR: 2.52, 95%CI: 1.02, 6.22, p=0.045) and to have a high waist circumference (OR: 2.44, 95%CI: 1.07, 5.57, p=0.034) compared to those reporting 8h sleep. Jamaican women reporting ≤6h sleep (OR: 2.53, 95%CI: 1.19, 5.36, p=0.016) and American women reporting 7h sleep (OR: 2.71, 95%CI: 1.17, 6.26, p=0.002) were more likely to be obese than those reporting 8h sleep. Conclusions: Associations between short sleep and CM risk factors were only evident in the American men and women and Jamaican women. Future interventions to reduce address CM risk through and sleep behavior modificationhealth may need to be country-specific when targeting high-risk populations.