1133 Racial and Ethnic and Sex Differences in the Association of Sleep Duration and Advanced Cardiovascular-kidney-metabolic Syndrome

Abstract Introduction Cardiovascular-Kidney-Metabolic Syndrome (CKM), a condition characterized by the comorbid occurrence of metabolic conditions, chronic kidney disease, and cardiovascular disease, can significantly increase the risk for early mortality. Sex, racial, and ethnic differences have been found, with men (compared to women) and Black individuals (compared to White individuals) being more likely to have advanced stage CKM (stages 3 and 4), suggesting the need to examine factors that may be contributing to advanced stage CKM. Poor sleep may be a determinant of CKM, given its link to cardiovascular, chronic kidney, and metabolic conditions independently. We examined associations of objective sleep duration and the occurrence of advanced-stage CKM, and whether the associations differed by sex and race and ethnicity. Methods We analyzed cross-sectional data from two cycles (2011-2012 & 2013-2014) of the NHANES study. Individuals were classified into five stages (0-4) of CKM. For the current analyses, individuals were further classified as having advanced CKM (stages 3-4) vs no advanced CKM (stages 0-2). Sleep duration was obtained via actigraphy across a nine day period and coded as short (< 7 hours), recommended (> 7 and < 9 hours), and long (> 9 hours) sleep. Sex and race and ethnicity stratified logistic regressions were fit to determine the association of sleep duration and CKM adjusting for sociodemographic factors, smoking, alcohol use, and depressive symptoms. Results The sample (n=4510; Mage = 48.9) was 50% female, 22% Latinx, 42% White, 21% Black, and 13% Asian. Approximately 37% had short sleep duration, 13% had long sleep duration, and 17% had advanced CKM. In fully adjusted models, long compared to recommended sleep duration was associated with an increased odds of advanced CKM for men (aOR: 1.84 CI: [1.05, 3.24]) and Latinx individuals (aOR: 4.64 CI:[2.07, 10.40]). Sleep duration was not associated with advanced CKM in women, or White, Black, or Asian individuals. Conclusion Long sleep duration was associated with higher odds of advanced stage CKM among men and Latinx individuals. While cross-sectional, findings may suggest that interventions to improve sleep may reduce the burden of CKM among these populations. Support (if any) NIH 5T32HL130025-09.