The Role of Race/Ethnicity and Gender in the Association between Inadequate Sleep and Hypercholesterolemia

Abstract

Background: Evidence links aberrant sleep durations with elevated serum cholesterol levels or, hypercholesterolemia (HC), an established risk factor for coronary heart disease (CHD). Few studies have assessed the relationship between key sociodemographic indicators including gender and race/ethnicity and HC. Methods: A total of 40,679 Americans who participated in the 2008-2009 National Health Interview Survey (NHIS) provided data for this cross-sectional analysis. Participants were recruited using a nationally representative cross-sectional household interview survey, which uses a multi-stage area probability design. Participants provided sociodemographic information, physician-diagnosed chronic conditions, and habitual sleep duration, categorized as <6 hours, or >8 hours, referenced to 7 hours. We used NHIS-provided weights to adjust for use of complex design. Results: Of the total sample (n=40,679), 85% reported their race/ethnicity as non-Hispanic white and 15% as non-Hispanic black; 56% of the participants were female. Adjusted logistic regression analyses showed significant association between sleep duration and presence of HC among blacks, but not among whites. Blacks reporting short (<6 hours) or long sleep durations (>8 hours) had a greater risk of HC relative to blacks sleeping 7 hours habitually [OR=1.12, 95% CI: 1.11-1.13; OR=1.13, 95% CI: 1.12-1.14; p<0.001, respectively]. Black females reporting short or long sleep duration had greater risk of reporting HC compared with black males sleeping 7 hours [OR=1.11, 95% CI: 1.10-1.11; OR=1.10, 95% CI: 1.10-1.10; p<0.001, respectively]. Conclusion: Our study supports the relationship between inadequate sleep and traditional risk factors for CHD, namely, HC. Future lifestyle interventions should consider the role of sleep in addressing CHD risk and CHD morbidity.