Racial/ethnic minorities have greater declines in sleep duration with higher risk of cardiometabolic disease: An analysis of the U.S. National Health Interview Survey

Objective: Habitual insufficient sleep may contribute to cardiometabolic disease in the United States, particularly among racial and ethnic minorities. However, there is mixed evidence on secular trends in U.S. sleep duration. Study design: Cross-sectional data from 413,417 individuals were acquired from the National Health Interview Survey from 2005–2018. Variables included self-reported sleep duration as well as lifetime diagnosis of hypertension, coronary heart disease, diabetes, and pre-diabetes, and obesity. Population-weighted robust Poisson models estimated annual trends in sleep duration and the prevalence risk ratios (PRR) of cardiometabolic disease as a function of sleep duration. Setting: Population-based survey. Results: Daily sleep duration decreased -0.62 min ([-0.71, 0.54], p < 0.01) annually from 2005–2018. However, this decline began only after 2010, when sleep duration fell by 1.04 min ([-1.21, -0.86], p < 0.01) each year. This trend varied by race (two-way ANOVA, p = 0.02), such that Mexican Hispanic individuals saw a greater decline (-1.83 [-2.37, -1.30] min per year, p < 0.01) than whites (-0.83 [-1.02, -0.64] min per year, p < 0.01). Additionally, a 1-h loss in daily sleep duration was linked to 4% greater prevalence of hypertension (PRR: 1.04, [1.04, 1.05]), 3% greater prevalence of diabetes (PRR: 1.03 [1.01, 1.05]), and 8% greater prevalence of obesity (PRR: 1.08 [1.07, 1.09]) after adjusting for age, sex, employment, marital status, and survey year. Conclusions: There is a secular decline in U.S. daily sleep duration that is greater among Mexican Hispanic individuals. Moreover, reduced sleep duration is associated with more prevalent cardiometabolic disease.