Association of weekend catch-up sleep with the atherosclerotic cardiovascular disease risk score: a hypothesis-generating study from US and Korean National Health and Nutrition Examination Surveys

A proportion of the populations sleeps longer on the weekends. We investigated a possible association between weekend catch up sleep (WCUS) and a known index of later development of atherosclerotic cardiovascular disease (ASCVD). We tested for an association of WCUS and ASCVD risk scores in 2 existing datasets. We analyzed national data from the 2019-2021 KNHANES (n = 11,502) and the 2017-2020 NHANES (n = 2,135). WCUS duration from self-reported questionnaires was categorized as ≤0 hours, >0-1 hours, 1-2 hours, and >2 hours. The ASCVD risk score estimating a 10-year risk of ASCVD events was categorized into low (<7.5%), intermediate (7.5%-20%), and high (≥20%) groups. WCUS (>2 hours) was inversely associated with the high ASCVD risk group in the KNHANES (adjusted odds ratio [aOR] = 0.19, 95% confidence interval [CI]: 0.08-0.45), but not in the NHANES. The inverse association of WCUS (>2 hours) with the high ASCVD risk group was shown only in the KNHANES, independent of weekday sleep duration (aOR = 0.20, 95% CI: 0.07-0.51 for <6 hours; aOR = 0.17, 95% CI: 0.07-0.39 for ≥6-8 hours; aOR = 0.13, 95% CI: 0.03-0.63 for ≥8 hours). However, WCUS (>2 hours) showed no significant association with the high ASCVD risk group in weekday sleep duration subgroups. The apparent association between WCUS and ASCVD in an existing dataset underscore the need to investigate WCUS in prospective studies.