Overall Sleep Quality Is Associated With Advanced Stages in Patients With Cardiovascular-Kidney-Metabolic Syndrome

In 2023, the American Heart Association defined the concept of cardiovascular-kidney-metabolic (CKM) syndrome as a health disorder ascribed to connections among obesity, diabetes, chronic kidney disease, and cardiovascular disease. We aim to examine the association between overall sleep quality and advanced CKM syndrome.

This cross-sectional study used data on US adults from the National Health and Nutrition Examination Survey 2015 to 2020. Overall sleep quality was evaluated by summarizing 5 sleep behaviors: sleep duration, trouble sleeping, daytime sleepiness, snoring, and nocturia. CKM syndrome was classified into 5 stages: stage 0, no risk factors; stage 1, excess adiposity; stage 2, metabolic risk factors and kidney disease; stage 3, subclinical cardiovascular disease; and stage 4, clinical cardiovascular disease. CKM syndrome stages 3 and 4 are considered advanced. The association between overall sleep quality and advanced CKM syndrome was assessed using a multivariable weighted logistic regression model.

Of the 12 245 adults included in our study, 10 607 participants met the criteria for CKM syndrome (stage ≥1), and 8930 were categorized into nonadvanced CKM syndrome, while 1677 were categorized into advanced CKM syndrome. Compared with patients with CKM syndrome in the low-sleep-quality group, the adjusted odds ratios for advanced CKM syndrome were 0.68 (95% CI, 0.54-0.87) for those in the moderate sleep quality group and 0.55 (95% CI, 0.40-0.75) for those in the high-sleep-quality group, respectively.

Patients with CKM syndrome with higher overall sleep quality had a lower likelihood of being in advanced stages.