Sleep duration Ratio, a novel parameter associated with a reduced risks of coronary artery disease and myocardial infarction: findings from NHANES 2017–2023

Background Cardiovascular disease (CVD) is a leading cause of death worldwide. Weekend sleep recovery (WSR), the practice of extending sleep on weekends to compensate for weekday sleep loss, may influence cardiovascular health. This study examines its association with coronary artery disease (CAD) and myocardial infarction (MI) using data from the National Health and Nutrition Examination Survey (NHANES).Methods A cross-sectional study of 14,335 NHANES participants analysed self-reported weekday and weekend sleep durations. The weekend-to-weekday sleep duration ratio (SDR) was calculated, classifying participants as WSR (SDR > 1) or non-WSR (SDR ≤ 1). Multivariate logistic regression models, adjusted for demographics and comorbidities, assessed the association between WSR and CAD/MI risk.Results Participants had a mean age of 43.9 ± 23.4 years, 52.5% were female, 4.83% had CAD, and 4.46% had MI. The mean weekday and weekend sleep durations were 7.7 ± 1.7 and 8.3 ± 1.8 h, respectively, with 64.8% having WSR. WSR was associated with a reduced risk of CAD and MI (OR = 0.79, 95% CI: 0.67–0.93, p = 0.005), particularly among those with 5–6 h of weekday sleep, older adults, White individuals, and those with diabetes or hypertension. The protective effect was also observed in smokers and individuals with class I and III obesity, but was not significant in Black individuals, non-smokers, or those without obesity.Conclusions WSR is associated with lower CAD and MI risks, particularly in those with intermediate weekday sleep and specific subgroups. However, its impact varies across populations, warranting further research.