Objective short sleep duration (SSD) is associated with daytime sleepiness, whereas obstructive sleep apnea (OSA) is associated with obesity, dyslipidemia, and hypertension, according to study results published in CHEST. Both SSD and OSA may help predict the risk for these variables in patients with these disorders.

Patients who participated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) and underwent sleep evaluation were enrolled in the analysis (N=2064). Assessments included clinical evaluations, sleep questionnaires, home sleep monitoring, and wrist actigraphy. The investigation defined OSA and SSD as an apnea-hypopnea index of ≥15 events/h and a mean sleep duration of <6 hours, respectively. Researchers evaluated whether OSA and SSD independently correlated with daytime sleepiness, prevalent cardiometabolic risk factors, and anxiety/depressive symptoms.

In the overall sample, the frequency rates of OSA and SSD were reported in 32.9% and 27.2% of patients, respectively. The adjusted analysis found an independent association between excessive daytime sleepiness and SSD (odds ratio [OR], 1.44; 95% CI, 1.17-1.79). No association was found between OSA and daytime sleepiness (OR, 1.10; 95% CI, 0.88-1.38). Independent associations were observed only between OSA and prevalent obesity (OR, 3.89; 95% CI, 3.07-4.92), hypertension (OR, 1.31; 95% CI, 1.03-1.66), and dyslipidemia (OR, 1.25; 95% CI, 1.00-1.55).

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Study limitations included the cross-sectional design and the likely heterogenous SSD population.

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“The additional lack of association of SSD with obesity, dyslipidemia, and diabetes in this large cohort reinforces the potential need to reappraise the evidence on subjective SSD and cardiometabolic risk factors,” the researchers wrote.


Drager LF, Santos RB, Silva WA, et al. OSA, short sleep duration, and their interactions with sleepiness and cardiometabolic risk factors in adults: the ELSA-Brasil study [published online March 25, 2019]. CHEST. doi:10.1016/j.chest.2018.12.003