ArticleBMC public health2025
Identifying sleep patterns as a synthetic signature in metabolic comorbidities using a stratified medicine approach.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAbundant evidence suggests that sleep is closely associated with metabolic diseases. However, studies focusing on sleep patterns in relation to metabolic comorbidities defined as the coexistence of obesity, type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, hyperuricemia, and non-alcoholic fatty liver disease (NAFLD) remain limited. This study aimed to explore the association between sleep patterns and both metabolic comorbidities and individual metabolic diseases using novel analytical methods.
methodsA total of 4,970 participants was included. Four sleep-related factors and six metabolic diseases were examined. Multiple correspondence analysis (MCA), K-means clustering, logistic regression, and subgroup analysis were applied to assess associations between sleep patterns and metabolic conditions.
resultsMCA and clustering of sleep factors identified three categories of sleep patterns: good sleep pattern (GSP), intermediate sleep pattern (ISP), and poor sleep pattern (PSP). Within the PSP group, 77.9% had a late bedtime, 83.7% reported poor or very poor sleep quality, 90.4% slept fewer than 7 h per night, and 29.1% snored. After adjusting for sex, age, and other confounders, PSP was associated with a 34.5% higher odds of metabolic comorbidities compared with GSP, with an even stronger association observed in men (51.9%). ISP was not associated with metabolic comorbidities overall, but was associated with increased odds of T2DM (19.4%) and NAFLD (23.4%). Specific sleep factors, including consistently having a late bedtime and snoring, were associated with higher odds of metabolic comorbidities by 67.7% [OR (95%CI): 1.677 (1.059-2.658)] and 46.4% [OR (95%CI): 1.464 (1.179-1.819)], respectively. Mediation analysis indicated that body mass index (BMI) explained only 31.58% of the total effect of sleep patterns on comorbidity risk in men.
conclusionSleep factors aggregated into three prevalent sleep patterns, with strong internal correlations observed within each pattern. PSP was associated with increased odds of metabolic comorbidities, with this association being pronounced in all participants and men. Notably, BMI served as a partial mediator of this relationship in the male subgroup. ISP showed significant associations with T2DM and NAFLD, highlighting their clinical relevance. These findings emphasize the role of sleep in metabolic health and support the need for longitudinal sleep interventions and strategies to improve sleep conditions.
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